breast biopsy

Discussion in 'MRCS Forum' started by Lona., Feb 4, 2008.

  1. Lona.

    Lona. Guest

    Q. A 35-year-old woman undergoes her first screening mammogram. Which of the following mammographic findings would require a breast biopsy?

    a- Breast calcifications larger than 2 mm in diameter
    b- Five or more clustered breast micro calcifications per square centimeter
    c- A density that effaces with compression
    d- Saucer-shaped micro calcifications
    e- Multiple round well-circumscribed breast densities
  2. Lona.

    Lona. Guest

    Answer: b. (Schwartz, 7/e, pp 543-546) breast biopsies have traditionally been performed to obtain histology for clinically suspicious palpable masses. However, in more recent years, the advent of screening mammography has led to the discovery of nonpalpable but radiograhically suspicious breast lesions that have a strong correlation with breast cancer. These nonpalpable, mammographically detected lesions are (1) breast calcifications the are (a) smaller than 2 mm, (b) punctuate, microlinear, or branching and (c) clustered along ducts or concentrated in clusters greater than five calcifications per square centimeter; (2) stellate-shaped lesions; (3) masses with ill-defined borders or nodular contours; (4) solitary dominant masses that are significantly larger than any other mass in either breast; and (5) areas of increased noneffacing tissue density or distorted breast architecture. A parenchymal density that effaces with compression represents normal glandular tissue. Saucer-shaped micro-calcifications are seen in patients with microscopic cystic disease, a benign condition. Multiple round well-circumscribed densities are usually cysts, whose nature may be confirmed with breast sonography.

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