Radiology Written Boards Mammography
Terms
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Magnification Views:
Dose
Contrast
Exposure -
Mag views have higher dose and exposure time.
Contrast is same. -
Tubular Carinoma:
Who? - Tubular carcinoma is most common in women aged 40–60 years
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Tubular Carcinoma:
Prognosis? - The prognosis for pure tubular carcinoma is excellent
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Tubular Carcinoma:
Mammogram findings? -
Like a radial scar...
-translucent, oval or circular areas at the center of the radiating structure
-long, thin spicules and clumped spicules -
Inflammatory Breast Carcinoma:
Who?
How Common?
Where? -
Women, avg age 52.
1-4% of cancers.
Left breast more common. -
Inflammatory Breast Carcinoma:
Prognosis? - Poor
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Inflammatory Breast Carcinoma:
Mammogram Findings? -
Mass
Calcifications
Increased Density
Stromal and skin thickening -
Lobular Carcinoma:
How Common?
Where? -
5-10 % of breast cancers
often multifocal and bilatera. -
Lobular Carcinoma:
Histology? -
linear arrays of cells
extraductal -
Lobular Carcinoma:
Mammogram Findings: -
architectural distortion
asymetric density
Microcalcifications are RARE -
Medullary Breast Cancer:
Frequency
Age? -
5%
Younger women -
Medullary Breast Cancer:
Mammographic Findings -
Round or Oval mass
Lobulations/Serrations at Margin
Noncalcified - Focal asymetric density
- It is visible as asymmetry of tissue density with similar shape on two views, but completely lacking borders and the conspicuity of a true mass
- Architectural distortion
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Distorted with no definite mass visible.
Includes:
Spiculations radiating from a point
Focal retraction or distortion of the edge of the parenchyma - Eggshell / Rim Calcifications
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thin calcified capsules of spherical BENIGN lesions in the breast.
-usually cysts, but fibroadenomas may sometimes calcify in a fine, rim like fashion.
-delicate, lace-like
-may compromise ultrasound - MILK OF CALCIUM
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-precipitated, amorphous calcium particles, floating within small cysts
-tea cup appearance - DYSTROPHIC
- irregular, dense, sometimes inhomogeneous, appear in post-irradiated breast or following trauma, including surgery.
- PUNCTATE CA++
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-small, less than 5 mm.
-regular, dense, pinpoint, round or oval deposits.
-represent involuting breast structures
-BIRADS II - AMORPHOUS or INDISTINCT CA++
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-Round, flake-shaped, small and hazy, calcifications that do not change position
-may be innumerable small particles glued together on mag views
-Intracystic calcifications v adenosis v cancer
BIRADS III or IV - HETEROGENEOUS or PLEOMORPHIC CA++
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-granular, comma-shaped, pointed, fine linear interrupted or branching types, which can be irregular in shape and of different size
-BIRADS IV or V - CASTING CA++
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-distinctive fine, linear, branching pattern
-formed by necrotic tissue in duct
-BIRADS V - Architectural distortion without calcification or mass
- Invasive lobular carcinoma