Radiology Notes

My notes during radiology residency, fellowship, and beyond…

Archive for the ‘mammography’ Category

Single Well Circumscribed Breast Lesion

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Benign

  • nipple
  • skin lesion
  • cyst
  • inflammatory lymph node
  • fibroadenoma
  • papilloma
  • hamartoma

Malignant

  • Phyllodes tumor
  • mets
  • medulary carcinoma
  • mucoid carcinoma
  • colloid carcinoma

Written by lmwong

January 30, 2010 at 9:37 am

Multiple Well Circumscribed Breast Lesions

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Benign

  • Skin lesions
  • Inflammatory nodes
  • cysts
  • fibroadenomas

Malignant

  • Mets

Written by lmwong

January 30, 2010 at 9:35 am

Ill-defined irregular breast opacities

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Benign

  • fat necrosis
  • previous surgery
  • radial scar/CSL
  • Hamartoma
  • breast abscess
  • composite opacity

Malignant

  • Carcinoma

Written by lmwong

January 30, 2010 at 9:33 am

Breast Microcalcifications Differential

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Benign

  • Sclerosing adenosis
  • fibrocystic change
  • vascular
  • skin lesion

Malignant

  • DCIS
  • Invasive cancer

Written by lmwong

January 30, 2010 at 9:32 am

Edematous Breast Differential

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Benign

  • breast abscess
  • medical – heart failure
  • fluid overload, etc.
  • radiotherapy
  • recent surgery

Malignant

  • Inflammatory carcinoma

Written by lmwong

January 30, 2010 at 9:30 am

BIRADS

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0__ Incomplete: Your mammogram or ultrasound didn’t give the radiologist enough information to make a clear diagnosis; follow-up imaging is necessary

1__ Negative: There is nothing to comment on; routine screening recommended

2__ Benign: A definite benign finding; routine screening recommended

3__ Probably Benign: Findings that have a high probability of being benign (>98%); six-month short interval follow-up

4__ Suspicious Abnormality: Not characteristic of breast cancer, but reasonable probability of being malignant (3 to 94%); biopsy should be considered

5__ Highly Suspicious of Malignancy: Lesion that has a high probability of being malignant (>= 95%); take appropriate action

6__ Known Biopsy Proven Malignancy: Lesions known to be malignant that are being imaged prior to definitive treatment; assure that treatment is completed

Written by lmwong

January 28, 2010 at 4:12 pm

Stereotatic Biopsy Dictation

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CLINICAL HISTORY: [x] year old woman referred for stereotactic core biopsy of a cluster of indeterminate microcalcifications in the [left or right] breast noted on recent mammography at [place and date].

Technique: [x] breast stereotactic core biopsy. Unilateral [digital] mammography. Specimen radiography. Dated [x].

PROCEDURE: Preliminary grid localizing film confirms a [x] cm cluster of microcalcifications in the [location within the breast].

Following universal protocol, patient and site verification was performed with a “time out” prior to the procedure.
After obtaining informed consent, the patient was positioned prone on the stereotactic table and the target was localized with digital images. A [x] approach was used. The skin was cleansed with Chloraprep. Cutaneous and deeper subcutaneous anesthesia was achieved using [x] cc of 1% Lidocaine and [x] cc’s of 1% Lidocaine containing epinephrine respectively. A small scalpel incision was made. A 9 gauge ATEC probe was inserted and its accurate position confirmed with pre and post fire images on the first pass. A total of [x] core biopsy specimens were obtained.

[#of radiographs] specimen radiographs revealed calcification in [x] cores. Cores containing radiographically evident calcium were sent in one container of formalin and cores not containing radiographically evident calcium were sent in another container of formalin for pathologic analysis, results pending. A [x] clip was [x] deployed to mark the biopsy site.

Post procedure cranial caudal and medial lateral projections disclose the clip to be at the target site. There [ are or are no ] residual microcalcifications noted at the biopsy site.

Following the procedure, the wound was cleansed and compressed. Steri strips and sterile gauze were applied and the patient was given post biopsy instructions. She left the department in good condition. Dr. [x] was in attendance during the entire procedure.

CONCLUSION: Status post stereotactic core biopsy of [right/left]

Written by lmwong

April 7, 2008 at 9:41 pm

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