1. Mock Oral
Boards

4. What do you want to do?

5. Last
Year

6. Last
Year
What next?

9. What is this?

10. 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

11. Image from UofWash Teaching File

12. Image from UofWash Teaching File

13. Image from UofWash Teaching File

14. Case 2 Keys
DDx for a fat-containing lesion
(hamar toma, lipoma, oil cyst, galactocele)
Final diagnosis = hamartoma

17. What do you want to do?

20. Impression?

21. Case 3 Keys
Workup for a focal asymmetry
(lateral, spot compression and ultrasound)
BIRADS 4: Suspicious finding (IDC)

24. What do you want to do?

26. Impression?

27. 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)

30. Right Axilla

31. Impression?
Right Axilla

32. Case 5 Keys
Differential diagnosis for bilateral adenopathy
Lymphoma
Rheumatoid / Autoimmune
Granulomatous / Sarcoid
Systemic processes
Metastatic disease (less likely unless diffuse mets)

35. What do you want to do?

37. Impression?

38. Does this change anything?

39. 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.

42. Any questions?

45. Impression?

46. 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

50. Case 8 Keys
Intra- and extra-capsular silicone implant rupture
- linguine sign
- free silicone

52. Impression?

53. 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

56. Impression?

57. Case 10 Keys
Linear non-masslike enhancement in the central right
breast is suspicious
BIRADS 4: MRI guided biopsy is recommended

60. What do you want to do?

62. What next?

63. Ultrasound is negative,
what do you do?

64. What is this?

65. 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

69. Case 12 Keys
Aunt Minnie appearance:
Neurofibromatosis
- multiple superficial round masses
- nipple deformity

70. Good Luck!