Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Mammo Guide to the Boards

10,606 views

Published on

MammoGuide.com presents an overview of breast imaging for the ABR oral board exam.

Published in: Health & Medicine, Education
  • DOWNLOAD THIS BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download Full EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download Full doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book THIS can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer THIS is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story THIS Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money THIS the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths THIS Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • Your wife will never find out! .. Just send me a message and ask to F.U.C.K.  http://t.cn/AiuW9zn5
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • ..............ACCESS that WEBSITE Over for All Ebooks ................ ......................................................................................................................... DOWNLOAD FULL PDF EBOOK here { https://urlzs.com/UABbn } ......................................................................................................................... Download Full EPUB Ebook here { https://urlzs.com/UABbn } .........................................................................................................................
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • GIVE HER A BIGGER PACKAGE THIS VALENTINE'S DAY ➤➤ https://tinyurl.com/yy3nfggr
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • New $31,515 USD profit system revealed. using an automated software that predicts the winners for Soccer, Horse racing and even major sports such as NBA, NFL, NHL, MLB! ★★★ https://tinyurl.com/yxcmgjf5
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here

Mammo Guide to the Boards

  1. 1. Oral Boards Simplified
  2. 2. How to take a case
  3. 3. Systematic approach to every breast case Breast density Finding BIRADS (0 or 2) ---------------------------------------------- Workup Specific findingsFinal Impression and BIRADS (2 or 4)
  4. 4. Systematic approach to every breast case Breast density Fatty Scattered Hetereogenously dense Extremely dense
  5. 5. Systematic approach to every breast case Breast density Finding MassAsymmetry / Focal asymmetry Calcifications Architectural distortion
  6. 6. Systematic approach to every breast case Breast density Finding BIRADS (0 or 2)---------------------------------------------------------
  7. 7. Systematic approach to every breast case Breast density Finding BIRADS (0 or 2)---------------------------------------------- Workup Additional views / modalities
  8. 8. Systematic approach to every breast case Breast density Finding BIRADS (0 or 2)---------------------------------------------- Workup Specific findings
  9. 9. Systematic approach to every breast case Breast density Finding BIRADS (0 or 2) ---------------------------------------------- Workup Specific findingsFinal Impression and BIRADS (2 or 4)
  10. 10. What to say
  11. 11. “The breasts are heterogenously dense” “There is a focal asymmetry in the superior and central right breast”“This is a BIRADS 0, additional evaluation is required”
  12. 12. ------------------------------------------------------------------------------------------------ “I would do a lateral view, spot compression and an ultrasound”“The focal asymmetry persists on the lateral and spot views. Ultrasound demonstrates an irregularhypoechoic mass with posterior acoustic shadowing” “This is a suspicious mass. BIRADS 4, biopsy is recommended.”
  13. 13. Final BIRADS at Boards Avoid BIRADS 3All cases will be BIRADS 2 Benign or BIRADS 4 Suspicious
  14. 14. 15 Must-Know CasesWorkups Aunt Minnies Special 1 1 1 2 2 2 3 3 3 4 4 4 5 5 5
  15. 15. Case 1
  16. 16. Case 1: Solid mass1. Specific diagnosis is not important2. How to workup the finding is the key3. Be consistent – Suspicious descriptors  BIRADS 4 Benign descriptors  BIRADS 2
  17. 17. Mass Workup Lateral Spot Mag Ultrasound
  18. 18. Mass descriptors - MammoShape (round, oval, lobular, irregular)Margins (well-circumscribed, microlobulated, partially obscured, indistinct, spiculated)Density (high density, isodense, low density, fat-containing)
  19. 19. Mass descriptors - USShape (oval, round, irregular)Echogenicity (anechoic, hyperechoic, complex/mixed, hypoechoic, isoechoic)Margins (well-circumscribed, indistinct, angular, microlobulated, spiculated)Orientation (wider than tall, taller than wide)Posterior features (shadowing, increased thru transmission, none)
  20. 20. For the boards:We biopsy all new solid masses
  21. 21. Case 2
  22. 22. You can use the mouse as a magnifying glass during the exam
  23. 23. Case 2: Suspicious calcifications
  24. 24. Calcifications Lateral Mags in CC / 90 (Full or spot)
  25. 25. Case 3
  26. 26. Case 3: Suspicious focal asymmetry
  27. 27. Focal asymmetry /Architectural distortion Lateral Spot Compression +/- Ultrasound Same workup for architectural distortion as for focal asymmetry
  28. 28. Case 4
  29. 29. Rolled views
  30. 30. Case 4: Suspicious asymmetry Boards cases will not be this subtle
  31. 31. Asymmetry Only on CC Rolled CC’s Spot compression Only on MLO Lateral Spot compression
  32. 32. Case 5
  33. 33. Case 5: Suspicious palpable mass Always look for a BB on the skin = palpable
  34. 34. Palpable Workup Put BB on skin Lateral Spot in tangent Ultrasound* Any patient < 30 years old, start with ultrasound *
  35. 35. 15 Must-Know Cases Workups Aunt Minnies Special Mass CalcsFocal asym/arch dist Asymmetry Palpable
  36. 36. Case 6
  37. 37. Case 6: Skin Calcifications BIRADS 2
  38. 38. How to do a skin localization Place alpha- Keep patient in Remove from numeric grid compression. compression. Take over Place BB on skin image with BB incalcifications & directly over the tangent to prove image. calcs & image. calcs are in the skin
  39. 39. Milk of Calcium Skin calcificationsSecretory calcifications Hyalinized fibroadenoma Other Benign Calcifications
  40. 40. Case 7
  41. 41. Case 7: Breast Hamartoma BIRADS 2
  42. 42. Fat containing breast masses = BIRADS 2Lipoma Hamartoma Oil cyst
  43. 43. Case 8
  44. 44. Case 8: Bilateral intracapsular &left extracapsular implant rupture Linguine or keyhole sign = Intracapsular rupture Free silicone = Extracapsular rupture
  45. 45. Intracapsular Extracapsular
  46. 46. Intracapsular ExtracapsularStepladder sign Snowstorm sign
  47. 47. Case 9
  48. 48. Case 9: Fat Necrosis BIRADS 2
  49. 49. Fat Necrosis= oil cysts or coarse dystrophic calcs
  50. 50. Case 10
  51. 51. Case 10: Sternalis muscle BIRADS 2
  52. 52. 15 Must-Know Cases Workups Aunt Minnies Special Mass Benign calcs Calcs Fat containingFocal asym/arch dist Implant rupture Asymmetry Sternalis Palpable Fat necrosis
  53. 53. Case 11
  54. 54. Case 11: Complex cyst BIRADS 4
  55. 55. Simple Complicated ComplexBIRADS 2 BIRADS 3 BIRADS 4
  56. 56. Case 12
  57. 57. Case 12: Unilateral axillary adenopathy
  58. 58. Bilateral DDx Unilateral DDxLymphoma Mets – breast 1⁰Rheumatoid/Autoimmune Mets – non-breast 1⁰Granulomatous/Sarcoid InfectionSystemic processes
  59. 59. Case 13
  60. 60. Case 13: Multiple round masses BIRADS 2
  61. 61. Multiple round masses = BIRADS 2 Must be: Bilateral At least 3 masses Nonpalpable No new or suspicious findings
  62. 62. Case 14
  63. 63. Case 14: Suspicious left breast mass w/ pec invasion + axillary nodes
  64. 64. Mass NMLE
  65. 65. Main MRI finding will be obviousLook for secondary findings - multifocal disease - contralateral disease - axillary or IM adenopathy - pectoralis or skin involvement
  66. 66. Mass NMLE Shape Distribution (round, oval, lobulated, irregular) (focal, linear, ductal, segmental, regional, diffuse) Margins (smooth, irregular, spiculated) Enhancement Pattern (homo, hetero, stippled, clumped) Enhancement(homo, hetero, rim, internal septations)
  67. 67. Case 15
  68. 68. Case 15: Male IDC
  69. 69. Gynecomastia Male IDC Signs of Male IDC: - Eccentric mass - Skin thickening - Skin retraction
  70. 70. 15 Must-Know Cases Workups Aunt Minnies Special Mass Benign calcs Cysts Calcs Fat containing Axillary adenopathyFocal asym/arch dist Implant rupture Mult round masses Asymmetry Sternalis MRI Palpable Fat necrosis Male breast
  71. 71. Your Name HereAmerican Board of Radiology

×