Screening for Breast Cancer 5/17/16 – Flashcards

MAMMOGRAPHY- workhorse exam ULTRASOUND- usual secondary, sometimes primary study (if pregnant or lactating) MRI-problem solving or special study Nuclear Medicine Breast Imaging Others(Thermoscan, Breast light scan)

0 - Needs ADDITIONAL assessment Cone compression/magnification views/ US 1 - NORMAL 2 - BENIGN 3 - PROBABLY Benign Usual recommendation for 6 month f/u 4 - SUSPICIOUS Biopsy is recommended: approx 30 % + 5 - MALIGNANT Biopsy recommended/needed -approx 90 % +

SCREENING: Patient has NO breast complaints and is following ACR guidelines DIAGNOSTIC: Patient either has breast SYMPTOMS or palpable MASS OR has an ABNORMAL finding on screening mammogram.

*Craniocaudal and medolateral of each breat *COMPARISON WITH PREVIOUS EXAM *Computer assosicated diagnosis is oten used to improve accuracy

*Can improve ACCURACY as much as 10-15% *Is very useful in DETECTING subtle CALCIFICATIONS *Identifies potential ABNORMALITIES *Will often OVER CALL masses (Remember cant make diagnosis but brings your attention to it)

Symmetry/Asymmetry** Nodule margins-regular vs irregular** Irregular clustered microcalcification** Interval nodule development or growth Skin thickening or nipple retraction(peau d' orange)

*CYSTIC or SOLID( If its cytsti no more wokroup or biopsy) *TALL vs wife *Border definition *Shadowing *Through transmission *Vascular flow (malignant you would see abndomral blood flow it would also be tall and irregular borders)

Thru transmission sharp border, wide not tall

NO THRU transmission IRREGULAR border complex Tall not wide

*Mammography Primary screening modality Bi-Rads Classification Tomosynthesis-now coming available *Ultrasound-most common secondary study Commonly used for biopsy *MRI-if indications are present Nuclear medicine imaging-inconsistently applied, not commonly used

MAMMOGRAPHY-primary imaging method for both screening and diagnostic mammo ULTRASOUND-most common follow up study; is a common biopsy guide. Also used for evaluation of clinically palpable lesion(i.e. cyst vs solid) MRI-problem solving and workup-evolving also used for biopsy of occult lesions not seen on mammo/US