The document discusses various investigation methods for breast cancer including triple assessment, invasive methods like FNAC and core biopsy, and non-invasive methods like mammography, ultrasound, MRI, and sentinel lymph node biopsy. Triple assessment, using clinical, imaging and pathology findings, is 99.9% accurate for diagnosis. FNAC provides immediate results but has limitations while core biopsy analyzes tissue architecture. Mammography remains an important screening and diagnostic tool but has limitations like missed cancers in dense breasts. Ultrasound has benefits of no radiation and reproduciblity.

1. INVESTIGATIONINVESTIGATION
Dr sumer yadavDr sumer yadav

2. TRIPLE ASSESSMENTTRIPLE ASSESSMENT
Triple assessment
Clinical
1.AGE
2.EXAMINATION
Imaging
1.USG
2.MAMMOGRAPHY
Pathology
1.FNAC
2.CORECUT

3. TRIPLE ASSESSMENTTRIPLE ASSESSMENT
 ACCURATE 99.9%ACCURATE 99.9%
 DIAGNOSIS SHOULD BEDIAGNOSIS SHOULD BE
BASED ON TRIPLEBASED ON TRIPLE
ASSESSMENTASSESSMENT
LOVE & BAILEY 25THLOVE & BAILEY 25TH

4. INVESTIGATIONINVESTIGATION
 INVASIVEINVASIVE
 NONINVASIVENONINVASIVE

5. INVASIVEINVASIVE
FNACFNAC
CORE BIOPSYCORE BIOPSY
 IMAGE GUIDED BREAST BIOPSYIMAGE GUIDED BREAST BIOPSY
 STEREOTACTIC BIOPSYSTEREOTACTIC BIOPSY
 EXCISION BIOPSYEXCISION BIOPSY
 FROZEN SECTION BIOPSYFROZEN SECTION BIOPSY
 EDGE BIOPSYEDGE BIOPSY
 SENTINEL LYMPH NODE BIOPSYSENTINEL LYMPH NODE BIOPSY

6. NONINVASIVENONINVASIVE
 MAMMOGRAPHYMAMMOGRAPHY
 DUCTOGRAPHY & DUCTALDUCTOGRAPHY & DUCTAL
LAVAGELAVAGE
 ULTRASOUND & COLOURULTRASOUND & COLOUR
DOPPLERDOPPLER
 MRIMRI

7. FNACFNAC
 O P D BASISO P D BASIS
 IMMEDIATE RESULTIMMEDIATE RESULT
 EXPERT PATHOLOGISTEXPERT PATHOLOGIST
REQUIREMENTREQUIREMENT
 NO SCARNO SCAR
CONT.CONT.

8. FNAC PROCEDUREFNAC PROCEDURE
 DONE USING 21G OR 23 GDONE USING 21G OR 23 G
NEEDLENEEDLE
 LUMP HELD FIRMLYLUMP HELD FIRMLY
 NEGATIVE PRESSURENEGATIVE PRESSURE
ASPIRATIONASPIRATION
 BOTH AIR DRIED & 95%BOTH AIR DRIED & 95%
ALCOHOL FIXED SLIDEALCOHOL FIXED SLIDE
CONT.CONT.

9. FNACFNAC

10. DISADVANTAGE OF FNACDISADVANTAGE OF FNAC
 SAMPLING ERROR MISSINGSAMPLING ERROR MISSING
THE TUMOURTHE TUMOUR
 FALIURE TO ASPIRATEFALIURE TO ASPIRATE
Schirrhous acelluler carcinomaSchirrhous acelluler carcinoma
 FALSE POSITIVE HormoneFALSE POSITIVE Hormone
Therapy,Pregnancy,LactationTherapy,Pregnancy,Lactation
 IMP. CAN NOTIMP. CAN NOT
DIFFERANTIATE B/W DCIS &DIFFERANTIATE B/W DCIS &
INVASIVE DISEASEINVASIVE DISEASE

11. CORE BIOPSYCORE BIOPSY
 DONE UNDER LADONE UNDER LA
 ANALYSIS OF BREASTANALYSIS OF BREAST
TISSUE ARCHITECTURETISSUE ARCHITECTURE
 DIFF. B/W INSITU & INVASIVEDIFF. B/W INSITU & INVASIVE
 DIFF. DUCTAL CA. FROMDIFF. DUCTAL CA. FROM
LOBULAR CA.LOBULAR CA.
 RECEPTOR STATUSRECEPTOR STATUS

12. CORE BIOPSYCORE BIOPSY

13. IMAGE GUIDED BIOPSYIMAGE GUIDED BIOPSY
 USED TO DIAGNOSEUSED TO DIAGNOSE
NONPALPABLE LEISIONNONPALPABLE LEISION
 ULTRASOUND LOCALIZATIONULTRASOUND LOCALIZATION
WHEN A MASS IS PRESENTWHEN A MASS IS PRESENT
ON USGON USG

14. Sonoguided core biopsySonoguided core biopsy

15. USG GUIDED BIOPSYUSG GUIDED BIOPSY

16. STEREOTACTIC BIOPSYSTEREOTACTIC BIOPSY
 DONE WHEN NO MASS ISDONE WHEN NO MASS IS
PRESENT (microcalcificationPRESENT (microcalcification
only)only)

18. MAMMOTEST BIOPSYMAMMOTEST BIOPSY
TABLETABLE

19. EXCISION BIOPSYEXCISION BIOPSY

20. EXCISION BIOPSYEXCISION BIOPSY
 INCISION SHOLD BEINCISION SHOLD BE
PLANNED SO THAT IT WILLPLANNED SO THAT IT WILL
BE INCLUDED IN EVENTUALBE INCLUDED IN EVENTUAL
MASTECTOMYMASTECTOMY

21. FROZEN SECTION BIOPSYFROZEN SECTION BIOPSY
 NOT ROUTINELY USEDNOT ROUTINELY USED
 USED WHEN FNAC FAILS ONUSED WHEN FNAC FAILS ON
TWO OCCASIONTWO OCCASION
 IN CASE OF NEGATIVE FNACIN CASE OF NEGATIVE FNAC
 DRAWBACK PATIENTDRAWBACK PATIENT
CANNAT DISCUSSCANNAT DISCUSS
TREATMENT POTIONTREATMENT POTION
OXFORD TEXT BOOKOXFORD TEXT BOOK

22. EDGE BIOPSYEDGE BIOPSY
 DONE ONLY WHEN THERE ISDONE ONLY WHEN THERE IS
ULCERATION & ORULCERATION & OR
FUNGATIONFUNGATION
 DIATHERMY SHOULD BEDIATHERMY SHOULD BE
AVOIDED.IT DISTORT THEAVOIDED.IT DISTORT THE
HISTOLOGY OF TUMOURHISTOLOGY OF TUMOUR

23. SENTINEL LYMPH NODESENTINEL LYMPH NODE
BIOPSYBIOPSY
 SENTIEL MEANS GUARDSENTIEL MEANS GUARD
 FIRST AXILLARY NODE DRAININGFIRST AXILLARY NODE DRAINING
THE BREASTTHE BREAST
 INVOLVEMENT BY TUMOUR CELLINVOLVEMENT BY TUMOUR CELL
GIVE PREDICTIVE IDEA ABOUTGIVE PREDICTIVE IDEA ABOUT
SPREAD TO OTHER NODESPREAD TO OTHER NODE
 IF SLNB IS NEGATIVE NODALIF SLNB IS NEGATIVE NODAL
DISSECTION CAN BE AVOIDEDDISSECTION CAN BE AVOIDED
CONT.CONT.

24. SLNBSLNB
 DONE IN T1 &T2 WITHOUTDONE IN T1 &T2 WITHOUT
CLINICALLY PALPABLE NODECLINICALLY PALPABLE NODE
 NOT DONE IN CLINICALLYNOT DONE IN CLINICALLY
PALPABLE NODE AS THERE ISPALPABLE NODE AS THERE IS
DISTORTION OF LYMPHATICDISTORTION OF LYMPHATIC
FLOWFLOW
 NOT DONE IN MULTICENTRIC &NOT DONE IN MULTICENTRIC &
MULTIFOCALAS INVOLVEMENTMULTIFOCALAS INVOLVEMENT
OF MANY LYMPHATIC TRUNKSOF MANY LYMPHATIC TRUNKS
CONT.CONT.

25. PROCEDUREPROCEDURE
 PREOPERATIVE ORPREOPERATIVE OR
PEROPERATIVEPEROPERATIVE
 INJECTION OF PATENT BLUE ORINJECTION OF PATENT BLUE OR
99mTC LABELLED COLLOID99mTC LABELLED COLLOID
ALBUMIN NEAR THE TUMOURALBUMIN NEAR THE TUMOUR
 DETECTED VISUALLY AS BLUEDETECTED VISUALLY AS BLUE
STAINING OR WITH A HAND HELDSTAINING OR WITH A HAND HELD
GAMMA CAMERAGAMMA CAMERA
 BIOPSIED WITH INCISION OVER ITBIOPSIED WITH INCISION OVER IT

26. SLNBSLNB

27. MAMMOGRAPHYMAMMOGRAPHY

28. MAMMOGRAPHYMAMMOGRAPHY
 LOW VOLTAGE HIGHLOW VOLTAGE HIGH
AMPERAGE X-RAYSAMPERAGE X-RAYS
 DOSE OF RADIATION 0.1cGyDOSE OF RADIATION 0.1cGy
 SAFE INVESTIGATIONSAFE INVESTIGATION
 MAY BE SCREENING ORMAY BE SCREENING OR
DIAGNOSTICDIAGNOSTIC
CONT.CONT.

29. SCREENINGSCREENING
MAMMOGRAPHYMAMMOGRAPHY
 TWO VIEWS ARE OBTAINEDTWO VIEWS ARE OBTAINED
 CRANIOCAUDAL &CRANIOCAUDAL &
MEDIOLATERL OBLIQUEMEDIOLATERL OBLIQUE
CONT.CONT.

30. CC VIEWCC VIEW
 CC VIEW PROVIDE BETTERCC VIEW PROVIDE BETTER
VISUALIZATION OF MEDIALVISUALIZATION OF MEDIAL
ASPECT OF BREAST &ASPECT OF BREAST &
PROVIDE BETTERPROVIDE BETTER
COMPRESSIONCOMPRESSION
CONT.CONT.

31. MLO VIEWMLO VIEW
 MLO VIEW IMAGES OFMLO VIEW IMAGES OF
GREATEST VOLUME OFGREATEST VOLUME OF
BREAST INCLUDING UPPERBREAST INCLUDING UPPER
OUTER QUDRANT &OUTER QUDRANT &
AXIILARY TAILAXIILARY TAIL
CONT.CONT.

32. DIAGNOSTICDIAGNOSTIC
MAMMOGRAPHYMAMMOGRAPHY
 USE VIEWS THAT BETTERUSE VIEWS THAT BETTER
DEFINE THE NATURE OFDEFINE THE NATURE OF
ABNORMALITYABNORMALITY
 90-degree LATERAL & SPOT90-degree LATERAL & SPOT
COMPRESSION VIEWSCOMPRESSION VIEWS
CONT.CONT.

33. DIAGNOSTIC VIEWSDIAGNOSTIC VIEWS
 90 degree lateral view used for90 degree lateral view used for
triangulate the exact locationtriangulate the exact location
along with the CC viewalong with the CC view
 Spot compression devise isSpot compression devise is
placed over a mammographyplaced over a mammography
abnormality & it improveabnormality & it improve
definitiondefinition
CONT.CONT.

34. COMPRESSION PLATECOMPRESSION PLATE

35. FEATURE OF CA ONFEATURE OF CA ON
MAMMOGRAPHYMAMMOGRAPHY
 SOLID MASS WITH ORSOLID MASS WITH OR
WITHOUT STELLATEWITHOUT STELLATE
FEATUREFEATURE
 ASYMMETRIC THICKENNINGASYMMETRIC THICKENNING
OF BREAST TISSUEOF BREAST TISSUE
 MICROCALCIFICATIONMICROCALCIFICATION
CONT.CONT.

36. GUIDELINE FORGUIDELINE FOR
MAMMOGRAPHYMAMMOGRAPHY
 IN NORMAL RISK EVERY 3IN NORMAL RISK EVERY 3
YEARS AFTER 20 YEARS OFYEARS AFTER 20 YEARS OF
AGEAGE
 AFTER 40 YEARS YEARLYAFTER 40 YEARS YEARLY
MAMMOGRAMMAMMOGRAM
NCCNNCCN
CONT.CONT.

37. MODIFICATION OFMODIFICATION OF
MAMMOGRAPHYMAMMOGRAPHY
 XEROMAMMOGRAPHYXEROMAMMOGRAPHY
XEROGRAPHY PLATE IS USEDXEROGRAPHY PLATE IS USED
WITH POSITIVE IMAGE.SELENIUMWITH POSITIVE IMAGE.SELENIUM
COATED FILM ARE USEDCOATED FILM ARE USED
 DIGITAL MAMMOGRAPY ISDIGITAL MAMMOGRAPY IS
COMPUTERIZED IMAGE OF THECOMPUTERIZED IMAGE OF THE
BREAST ALLOWS MOREBREAST ALLOWS MORE
ACCURATE STEREOTACTICACCURATE STEREOTACTIC
BIOPSYBIOPSY
CONT.CONT.

38. DISADVANTAGE OFDISADVANTAGE OF
MAMMOGRAPHYMAMMOGRAPHY
 5% OF BREAST CANCER5% OF BREAST CANCER
MISSED ON MAMMOGRAPHYMISSED ON MAMMOGRAPHY
 IN YOUNG PATIENT WITHIN YOUNG PATIENT WITH
DENSE BREAST BECOMEDENSE BREAST BECOME
LESS SENSITIVELESS SENSITIVE
CONT.CONT.

39. BREAST IMAGING REPORTINGBREAST IMAGING REPORTING
AND DATA SYSTEM [BI-RADS]AND DATA SYSTEM [BI-RADS]
 GRADE I-NEGATIVE, ANNUALGRADE I-NEGATIVE, ANNUAL
SCREENINGSCREENING
 GRADE 2-BENIGN LESION,ANNUALGRADE 2-BENIGN LESION,ANNUAL
SCREENINGSCREENING
 GRADE 3-PROBABLY BENIGNGRADE 3-PROBABLY BENIGN
LESION,6-MONTH F/UP MAMMOGRAMLESION,6-MONTH F/UP MAMMOGRAM
 GRADE 4- SUSPICIOUS OFGRADE 4- SUSPICIOUS OF
CARCINOMA,MAY BE BIOPSIEDCARCINOMA,MAY BE BIOPSIED
 GRADE 5- HIGHLY SUGGESTIVE OFGRADE 5- HIGHLY SUGGESTIVE OF
CARCINOMA,REQUIRE BIOPSYCARCINOMA,REQUIRE BIOPSY
 GRADE 6-KNOWN CARCINOMA,GRADE 6-KNOWN CARCINOMA,

40. MAMMOGRAPHYMAMMOGRAPHY

41. BREAST DENSITYBREAST DENSITY

42. BREST CALCIFICATIONBREST CALCIFICATION

43. MAMMOGRAM WITHMAMMOGRAM WITH
BREAST CANCERBREAST CANCER

44. MASS WITHOUTMASS WITHOUT
CALCIFICATIONCALCIFICATION

45. DUCTOGRAPHYDUCTOGRAPHY
 A DUCT IS ENLARGED WITHA DUCT IS ENLARGED WITH
DILATOR AND A BLUNTDILATOR AND A BLUNT
CANULA INSERTRD INTO THECANULA INSERTRD INTO THE
NIPPLE AMPULLANIPPLE AMPULLA
 0.1-0.2 ml CONTRAST0.1-0.2 ml CONTRAST
INJECTED & CC & MLOINJECTED & CC & MLO
MAMMOGRAPHY DONEMAMMOGRAPHY DONE
CONT.CONT.

46. DUCTOGRAPHYDUCTOGRAPHY
 INDICATED FOR NIPPLEINDICATED FOR NIPPLE
DISCHARGE SPECIALLY BLOODDISCHARGE SPECIALLY BLOOD
CONTAINING FLUIDCONTAINING FLUID
 INTRADUCTAL PAPILLOMASINTRADUCTAL PAPILLOMAS
SEEN AS SMALL FILLING DEFECTSEEN AS SMALL FILLING DEFECT
 CANCER APPEAR AS IRREGULARCANCER APPEAR AS IRREGULAR
MASS OR MULTIPLEMASS OR MULTIPLE
INTRALUMINAL FILLING DEFECTINTRALUMINAL FILLING DEFECT

47. DUCTAL LAVAGEDUCTAL LAVAGE
 MICROCATHETER OF 1cmMICROCATHETER OF 1cm
LENGTH IS INTRODUCEDLENGTH IS INTRODUCED
INTO THE DUCTAL OPENINGINTO THE DUCTAL OPENING
 10 ml SALINE IS INFUSED IN10 ml SALINE IS INFUSED IN
ITIT
 FLUID IS WITHDRAWN &FLUID IS WITHDRAWN &
CYTOLOGICAL ANALYSIS ISCYTOLOGICAL ANALYSIS IS
DONEDONE

48. USG & COLOUR DOPPLERUSG & COLOUR DOPPLER
 USG- NO IONIZING RADIATIONUSG- NO IONIZING RADIATION
 HIGHLY REPRODUCIBLEHIGHLY REPRODUCIBLE
 HIGH PATIENT ACCEPTIBILITYHIGH PATIENT ACCEPTIBILITY
 USEFUL IN YOUNG PATIENT WITHUSEFUL IN YOUNG PATIENT WITH
DENSE BREASTDENSE BREAST
 CAN LOCALIZE IMPALPABLECAN LOCALIZE IMPALPABLE
AREA OF BREAST PATHOLOGYAREA OF BREAST PATHOLOGY
 AXILLARY LYMPH NODE CAN BEAXILLARY LYMPH NODE CAN BE
SCANNED & PER CUTANEOUSSCANNED & PER CUTANEOUS
BIOPSY CAN BE TAKENBIOPSY CAN BE TAKEN

49. FEATURE OF USGFEATURE OF USG
 DEFINE CYATIC MASSDEFINE CYATIC MASS
 CYST ARE WELLCYST ARE WELL
CIRCUMSCRIBED,SMOOTH MARGIN &CIRCUMSCRIBED,SMOOTH MARGIN &
ECHO FREE CENTERECHO FREE CENTER
 BENIGN BREAST MASSES USUALLYBENIGN BREAST MASSES USUALLY
SHOW SMOOTH CONTOUR,WEAKSHOW SMOOTH CONTOUR,WEAK
INTERNAL ECHOES & WELL DEFINEDINTERNAL ECHOES & WELL DEFINED
ANT. & POST. MARGINANT. & POST. MARGIN
 BREAST CANCER HAS IRREGULARBREAST CANCER HAS IRREGULAR
WALLS, MAY HAVE SMOOTH MARGINWALLS, MAY HAVE SMOOTH MARGIN
WITH ACOUSTIC ENHANCEMENTWITH ACOUSTIC ENHANCEMENT
CONT.CONT.

50. USGUSG
 USG MAY BE USED TO GUIDEUSG MAY BE USED TO GUIDE
FNAC, CORE NEEDLEFNAC, CORE NEEDLE
BIOPSY & NEEDLEBIOPSY & NEEDLE
LOCALIZATION OF BREASTLOCALIZATION OF BREAST
LESIONSLESIONS
CONT.CONT.

51. DISADVANTAGE OF USGDISADVANTAGE OF USG
 USG DOES NOT DETECTUSG DOES NOT DETECT
LESION LESS THAN 1 cmLESION LESS THAN 1 cm
SCHWARTZ’SSCHWARTZ’S

52. MASS WITH CYSTIC &MASS WITH CYSTIC &
SOLID COMPONENTSOLID COMPONENT

53. COLOUR DOPPLERCOLOUR DOPPLER
 SPECIFICITY IN THE DETECTION OFSPECIFICITY IN THE DETECTION OF
AXILLARY NODAL METASTASESAXILLARY NODAL METASTASES
 USEFUL IN SELECTION OF PATIENTSUSEFUL IN SELECTION OF PATIENTS
FOR TREATMENT OF AXILLARY LYMPHFOR TREATMENT OF AXILLARY LYMPH
NODENODE
 HIGHER ACCURACY THANHIGHER ACCURACY THAN
CONVENTIONAL USGCONVENTIONAL USG
 MAMMOGRAPHY CAN NOT BE USEDMAMMOGRAPHY CAN NOT BE USED
FOR AXILLARY LYMPH NODEFOR AXILLARY LYMPH NODE
WALSH et alWALSH et al

54. COLOUR DOPPLER FOR CACOLOUR DOPPLER FOR CA

55. MRIMRI
 CURRENT INTEREST IS TOCURRENT INTEREST IS TO
SCREEN WOMEN OF HIGH RISKSCREEN WOMEN OF HIGH RISK
SUCH AS STONG FAMILYSUCH AS STONG FAMILY
HISTORY & KNOWN GENETICHISTORY & KNOWN GENETIC
MUTATIONMUTATION
 IN THESE SCERNING AT YOUNGIN THESE SCERNING AT YOUNG
AGE WITH DENSE BREASTAGE WITH DENSE BREAST
 SECONDLY TO SCREENSECONDLY TO SCREEN
CONTRALATERAL BREAST[5.7%]CONTRALATERAL BREAST[5.7%]
CONT.CONT.

56. ADVANTAGE OF MRIADVANTAGE OF MRI
 BEST IMAGING MODALITY INBEST IMAGING MODALITY IN
BREAST WITH IMPLANTSBREAST WITH IMPLANTS
 USEFUL TO DISTINGUISHUSEFUL TO DISTINGUISH
SCAR FROM RECURRENCESCAR FROM RECURRENCE
(AFTER 9 MONTH OF(AFTER 9 MONTH OF
RADIOTHERAPY)RADIOTHERAPY)
CONT.CONT.

57. DISADVANTAGE OF MRIDISADVANTAGE OF MRI
 LESS USEFUL THAN USG FORLESS USEFUL THAN USG FOR
MANAGEMENT OF AXILLA INMANAGEMENT OF AXILLA IN
BOTH PRIMARY & RECURRENCEBOTH PRIMARY & RECURRENCE
 BIOPSY WITH MRI GUIDANCE ISBIOPSY WITH MRI GUIDANCE IS
COMPLICATED DUE TOCOMPLICATED DUE TO
CONFIGURATIONCONFIGURATION
 BIOPSY TAKEN WITH SECONDBIOPSY TAKEN WITH SECOND
LOOK USGLOOK USG
CONT.CONT.

58. FEATURE ON MRIFEATURE ON MRI
 SPICULATIONSPICULATION
 CHANGES IN SKIN & NIPPLECHANGES IN SKIN & NIPPLE
 LYMPHOEDEMALYMPHOEDEMA

59. MRI SHOWING A LESIONMRI SHOWING A LESION

60. BREAST MRIBREAST MRI

61. BREAST COILBREAST COIL

62. CONTRAST ENHANCEMENTCONTRAST ENHANCEMENT
GADOLINIUM DTPAGADOLINIUM DTPA

63. NORMAL MRINORMAL MRI

64. EARLY BREAST CANCEREARLY BREAST CANCER

65. INVESTIGATION FOR METSINVESTIGATION FOR METS
 X-RAY CHEST-LOOK FOR PLEURALX-RAY CHEST-LOOK FOR PLEURAL
EFFUSION,CANNON BALL SECONDARIES INEFFUSION,CANNON BALL SECONDARIES IN
LUNGS,MEDIASTINAL LYMPHLUNGS,MEDIASTINAL LYMPH
NODE,SECONDARIES IN RIBNODE,SECONDARIES IN RIB
 USG OF LIVER FOR SECONDARIES-LOOK FORUSG OF LIVER FOR SECONDARIES-LOOK FOR
ASCITESASCITES
 X-RAY SPINE-OSTEOLYTIC SECONDARIESX-RAY SPINE-OSTEOLYTIC SECONDARIES
 CT SCAN THORAX & ABD.CT SCAN THORAX & ABD.
 CT SCAN BRAINCT SCAN BRAIN
 MRI SPINE/PELVIS-OSTEOLYTIC SECONDARIESMRI SPINE/PELVIS-OSTEOLYTIC SECONDARIES
 PET SCANPET SCAN
 BONE SCANBONE SCAN

66. NORMAL PET SCANNORMAL PET SCAN

67. PET WITH ABNORMALPET WITH ABNORMAL
LYMPH NODELYMPH NODE

68. PET WITH LIVERPET WITH LIVER
SECONDARIESSECONDARIES

69. MAMMOGRAM & BREASTMAMMOGRAM & BREAST
SPECIFIC GAMMA IMAGINGSPECIFIC GAMMA IMAGING

70. BREAST SPECIFIC GAMMABREAST SPECIFIC GAMMA
IMAGINGIMAGING
 EXPERIMENTAL METHODEXPERIMENTAL METHOD
 TRACER IS INJECTED IN ATRACER IS INJECTED IN A
VEINVEIN
 NUCLEAR MEDICINE SCAN ISNUCLEAR MEDICINE SCAN IS
DONEDONE
 MORE DOSE OF RADIATIONMORE DOSE OF RADIATION

71.  BONE SCAN USED IN STAGEBONE SCAN USED IN STAGE
2 & ONWARDS2 & ONWARDS
 CT ABD./USG/MRI USED INCT ABD./USG/MRI USED IN
STAGE 3 & 4STAGE 3 & 4