Fat
Cystic
Circumscribed Solid
Multiple
Spiculated and Scary
100
BI-RADS 2
What is a lipoma?
Lucent centered mass without peripheral calcifications, can be diagnosed on mammo alone.
100
A large simple cyst is seen and aspirated at the patient's request due to discomfort. This results in what BI-RADS classification?
What is BI-RADS 2 (benign)?
This is still benign, even if a procedure is performed.
100
The most common benign neoplasm in reproductive aged women. Presents as a firm, palpable mass.
What is a fibroadenoma?
Oval, circumscribed, equal density mass. May develop "popcorn" calcifications in older women when they degenerate.
100
Patient presents with at least 3 similar appearing circumscribe masses in her right breast. Negative mammographic evaluation of the left breast. BI-RADS?
BI-RADS 4.
Need at least 2 in one breast and 1 in the contralateral breast to categorize them as BI-RADS 2 (benign).100
This spiculated, invasive mass is most likely to present in a bilateral, multifocal pattern.
What is invasive lobular carcinoma?
200
What is an oil cyst (fat necrosis)?
Lucent mass with fine peripheral rim calcifications. Can be post-traumatic/post-surgical.
200
BI-RADS assessment given to a finding of multiple complicated cysts, containing low-level internal echoes or layering debris.
What is BI-RADS 2 (benign)?
BI-RADS 3 for a solitary complicated cyst.
200
Patient presents with a history of recently resected renal cell carcinoma presents with a new solitary circumscribed round mass.
What is a metastasis?
Solitary mets occur much more frequently than multiple mets. Usually melanoma, RCC.200
Multiple new masses in a non-ductal distribution are concerning for this.
What are metastases?
Typically hematologic from a non-breast primary.
200
Minimum cortical thickness of axillary lymph nodes that raises suspicion of metastasis in addition to focal cortical buldge, loss of the normal fatty hilum, and round shape.
What is 3 mm?
300
Intramammary lymph nodes are benign structures typically located in this quadrant of the breast.
What is the upper outer quadrant?
300
Cyst aspirate is considered benign if it appears one of these 3 ways/colors.
What are white, clear, and/or yellow?
300
Biopsy of a large, oval, circumscribed mass yields a pathologic result of a phyllodes tumor. What is the treatment of choice (6 month follow up mammogram, further evaluation with breast MRI, chemotherapy, radiation therapy, wide local excision).
What is wide local excision?
Imaging workup includes chest CT, not follow up mammography or breast MRI.
300
DAILY DOUBLE
What is NF1?
Multiple cutaneous neurofibromas.
300
A benign proliferative lesion of the breast which presents with architectural distortion.
What is a radial scar (complex sclerosing lesion when larger)?
Controversial management, sometimes surgically excised.
400
"Breast within a breast" - said no test, ever.
What is a hamartoma (fibroadenolipoma)?
Focal area of normal breast tissue demarcated by a pseudocapsule. Since it contains normal fibroglandular tissue, you can get breast cancer within a hamartoma!
400
A cyst with any solid features, given a BI-RADS 4.
What is a complex cystic and solid mass?
36% malignancy rate - DCIS, papillary carcinoma, high grade phyllodes, or invasive carcinoma with necrosis (triple negative).
400
This mass is the common cause of these two types of nipple discharge.
What are serous and bloody nipple discharge?
Intraductal papillomas present as isoechoic or hypoechoic masses in fluid filled ducts, usually a benign tumor of the lactiferous ducts between 30-50 years of age.
400
Multiple intraductal papillomas tend to occur in younger women, in more peripheral locations, and are less likely to produce pathologic nipple discharge. These are often seen in this distribution.
What is segmental?
Due to the ductal origin of the lesions.
400
DAILY DOUBLE
This is the subtype of invasive ductal carcinoma most likely to present as a spiculated mass, and carries a more favorable prognosis given its slow-growing nature.
What is tubular carcinoma?
Circumscribed ductal cancers are the "Peanut M&Ms", papillary, mucinous, and medullary.
500
Newly palpable mass in a 31 year old female.
What is a galactocele?
Fat-fluid level
500
Apocrine metaplasia or fibrocystic change may produce this entity, typically given a BI-RADS 3 in the absence of a solid component or internal vascularity.
What are clustered microcysts?
Several 2-3 mm cysts with thin septations, may eventually evolve into a simple benign cyst.
500
Pregnant patient presents with enlarging palpable mass at 35 weeks gestation. After core needle biopsy confirms this diagnosis, you inform the patient that it should regress after she stops breastfeeding.
What is a lactating adenoma?
Typically seen from 2nd trimester through postpartum period. Freely mobile, can be tender if rapidly enlarging.
500
An autosomal dominant disease characterized by multiple intradermal fat-density masses.
What is steatocystoma multiplex?
Intradermal cysts containing sebum.
500
This presents as areas of skin thickening and ecchymosis which mimic bruising, more common in patients who previously underwent breast conserving therapies.
What is (radiation associated) angiosarcoma?
Intensely enhancing mass(es) which can occur secondary to radiation, presenting in the dermis/subcutaneous tissues, or primarily in the breast parenchyma.