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MammoGuide Mock Boards

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MammoGuide Mock Boards

  1. 1. Mock Oral Boards
  2. 2. What do you want to do?
  3. 3. Last Year
  4. 4. Last Year What next?
  5. 5. What is this?
  6. 6. Case 1 Keys Ask for prior studies Know workup for a mass (lateral, spot mag, US) BIRADS 4: Suspicious finding (IDC) Wire localization prior to lumpectomy
  7. 7. Image from UofWash Teaching File
  8. 8. Image from UofWash Teaching File
  9. 9. Image from UofWash Teaching File
  10. 10. Case 2 Keys DDx for a fat-containing lesion (hamar toma, lipoma, oil cyst, galactocele) Final diagnosis = hamartoma
  11. 11. What do you want to do?
  12. 12. Impression?
  13. 13. Case 3 Keys Workup for a focal asymmetry (lateral, spot compression and ultrasound) BIRADS 4: Suspicious finding (IDC)
  14. 14. What do you want to do?
  15. 15. Impression?
  16. 16. Case 4 Keys Workup for left breast calcifications (lateral, magnification views in CC and ML) Milk of Calcium BIRADS 2: Benign finding (layering on the ML view)
  17. 17. Right Axilla
  18. 18. Impression? Right Axilla
  19. 19. Case 5 Keys Differential diagnosis for bilateral adenopathy Lymphoma Rheumatoid / Autoimmune Granulomatous / Sarcoid Systemic processes Metastatic disease (less likely unless diffuse mets)
  20. 20. What do you want to do?
  21. 21. Impression?
  22. 22. Does this change anything?
  23. 23. Case 6 Keys Circumscribed, isoechoic mass “Probable fibroadenoma, however we biopsy all new or palpable solid masses” Contrast enhanced MRI image shows no enhancement in the mass, consistent with a benign etiology.
  24. 24. Any questions?
  25. 25. Impression?
  26. 26. Case 7 Keys Ask if history of prior surgery and any prior studies Final diagnosis = Fat necrosis - coarse, dystrophic calcifications - extending along surgical scar - stable from prior studies
  27. 27. Case 8 Keys Intra- and extra-capsular silicone implant rupture - linguine sign - free silicone
  28. 28. Impression?
  29. 29. Case 9 Keys Try to compare to priors Look at each mass for any suspicious findings If no new, palpable or suspicious masses and at least 3 masses + bilateral = Multiple round masses BIRADS 2: Benign findings
  30. 30. Impression?
  31. 31. Case 10 Keys Linear non-masslike enhancement in the central right breast is suspicious BIRADS 4: MRI guided biopsy is recommended
  32. 32. What do you want to do?
  33. 33. What next?
  34. 34. Ultrasound is negative, what do you do?
  35. 35. What is this?
  36. 36. Case 11 Keys Subcentimeter mass in the superior left breast requires additional evaluation. If no sonographic correlate, need to biopsy another way. Do stereotactic core biopsy. Final Dx = IDC
  37. 37. Case 12 Keys Aunt Minnie appearance: Neurofibromatosis - multiple superficial round masses - nipple deformity
  38. 38. Good Luck!

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