Breast Mets and Additional Imaging Methods

Breast Mets spread TO:

• lymph nodes

• bone

• liver

  • brain

Breast Mets spreads from:

• melanoma

• non hodgkins

• sarcoma

• lung

  • ovary

What does CESM stand for?

contrast enhanced mammography

What does MRI stand for?

magnetic resonance imaging

What does CT stand for?

computerized tomography

What does NM stand for?

nuclear medicine

What does contrast-enhanced mammography do?

gets rid of noise in the breast to target lesions

-just because it enhances doesnt mean it is malignant 

What is this image showing?

contrast enhanced mammography

What is sentinel node procedure?

inject contrast into the nippler

What is the technique of sentinel node procedure

follow path to sentinel node

Color/Power Doppler:

• increase PRF

• low flow settings

• correct gain

  • minimal pressure

What does vascularity mean?

increase the indication of malignancy

decrease indicative of benign lesion

Color Power/Angio Imaging:

-highly sensitive imaging mode

-less angle dependent 

-not dependent speed or direction

-lack of low does not rule out malignancy

What uses sound like humming to determine the true size of a mass?

fremitus

What is this image showing?

fremitus

What is elastography?

additional sonographic information in the role of lesion assessment

Benign

soft

same size or smaller than 2D sonography

Malignant

stiff

larger than 2D sonography

What are diagnostic considerations for a single malignant characteristic excludes a lesion from being classified as benign?

-vascularity

-echogenicity

-pseudo mass

-growth compared to tissue planes

Ductal Ectasia nipple discharge appearance:

bilateral

greenish color

Milky discharge

bilateral

normal- pregnancy or lactation

abnormal- hormone imbalance/pituitary adenoma

Worrisome

unilateral

straw colored

bloody

US Interventional Procedures

• cyst aspiration

• fine needle aspiration cytology (FNA)

• drainage procedure

• preoperative needle wire localization

• large core needle biopsy

• vacuum assisted needle biopsy

• sentinel node biopsy

What are breast procedures?

wire localization

core biopsy

stereo biopsy

MRI biopsy

lymph node biopsy

savi placement