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19 Cards in this Set
- Front
- Back
Features of benign solid masses by US
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Hyperechoic
3 or fewer gentle lobulations Thin echogenic sharply marginated pseudo capsule Ellipsoid shape |
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Features of malignant masses by US
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Spiculated margin
Taller than wide Angular margins Shadowing Branching pattern Calcifications Microlobulated Disruption of tissue planes |
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Silicone implant, extracapsular rupture on US
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Snowstorm sign
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Silicone implant, intracapsular rupture on US
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Stepladder sign
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Breast US indications
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First line for patient < 30yo with palpable abnormality, breast feeding or pregnant
Further evaluation of mammographic findings Identification of palpable and non-palpable clinical sx Breast implant problem solving Nipple discharge problem solving US-guided bx 2nd look US following MRI Less likely: - Radiation tx planning - monitoring tx response - whole breast US screening - metastatic dz, unknown primary, negative mammo |
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Indications for Breast MRI
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Evaluate extent of disease in known CA
Metastatic LN with unknown primary Screening for contralateral breast in newly diagnosed CA Response to therapy Screening in pt with >20-25% lifetime risk: - BRCA1/2 - Untested primary relative of known BRCA1/2 carrier - Strong family hx - previous radiation tx <30yo |
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Horomonal enhancement on breast MRI:
- when is the best time to scan |
Between days 3-14 of the menstrual cycle.
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Fribroadenoma on MRI
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high T1W
High T2W Smooth enhancing mass Pesistant (increasing) kinetics |
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BIRADS descriptors for MASS (4)
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Round
Lobular Oval Irregular (suspicious) |
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BIRADS descriptors for MARGINS (5)
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Circumscribed
Microlobulated Obscured Indisctinct/Ill-defined (suspicious) Spiculated (suspicious) |
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BIRADS descriptors for DENSITY (4)
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Density compared to an equaly volume of breast tissue
High Isodense Low (but w/o fat) Fat-containing radiolucent |
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BIRADS descriptors for Typically-Benign CALCIFICATIONS (9)
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Skin
Vascular Coarse/Popcorn-like Large rod-like Round (> 1 mm) Punctate (<0.5 mm) Lucent-centered Eggshell/Rim Milk of calcium Suture Dystrophic - post traumatic or XRT |
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BIRADS descriptors for Intermediate concern, suspicious CALCIFICATIONS (2)
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Amorphous/Indistinct
Coarse Heterogeneous - may represent elvolving dystrophic |
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BIRADS descriptors for higher probability of malignancy CALCIFICATIONS (2)
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Fine pleomorphic
Fine linear/Fine linear branching |
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BIRADS descriptors for calcifications, DISTRIBUTION MODIFIERS (5)
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Diffuse/scattered
Regional (> 2 cc, > 1 segment) Grouped/clustered (> 5 calcs) Linear (suspicious) Segmental (suspicious) |
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BIRADS descriptors for SPECIAL CASES (4)
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Assymetric tubular structure
- dilated duct Intramammary LN Global assymetry - may be concerning if palpable Focal asymmetry - seen in 2 views but lacking characteristics of mass |
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BIRADS descriptors for ASSOCIATED FINDINGS (6)
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Skin retraction
Nipple retraction Skin thickening Trabecular thickening Skin lesion Axillary adenopathy |
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Subareolar mass
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Abscess
Montgomery gland cyst Papilloma Cancer |
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Breast mass in a pregnant patient
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Galctocele
Abscess Fibroadenoma Lactating adenoma Hematoma Fibrocystic change |