Notes in 12 Breast Intervention

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New Card	05/02/2023	Breast Imaging: Breast Interventions Ultrasound-guided core needle biopsy is usually performed via a {{c1::lateral::direction of}} approach
New Card	05/02/2023	Breast Imaging: Breast Interventions During ultrasound-guided breast biopsy, always keep the biopsy device {{c1::parallel}} to the chest wall or a…
New Card	05/02/2023	Breast Imaging: Breast Interventions During ultrasound-guided needle biopsy, it is important to document each needle {{c1::pass}} and needle {{c1::po…
New Card	05/02/2023	Breast Imaging: Breast Interventions The preferred modality for image-guided aspiration of an abscess is {{c1::ultrasound}}.
New Card	05/02/2023	Breast Imaging: Breast Interventions What size needle is used for the following procedure?Ultrasound-guided needle biopsy → {{c1::14}} gaugeUltrasoun…
New Card	05/02/2023	Breast Imaging: Breast InterventionsBreast cyst aspirate should be sent for cytology if it is {{c1::bloody}} or {{c2::clear}}.
New Card	05/02/2023	Breast Imaging: Breast Interventions Complex breast cysts should be {{c2::biopsied::aspirated or biopsied?}} with a {{c1::core}} device, targeting t…
New Card	05/02/2023	Breast Imaging: Breast Interventions Breast calcifications are most commonly biopsied via {{c1::stereotactic (2D mammo)}}-guidance.
New Card	05/02/2023	Breast Imaging: Breast InterventionsContraindications to stereotactic-guided breast biopsy include:→  A breast that measures < {{c1::3}} cm co…
New Card	05/02/2023	Breast Imaging: Breast Interventions{{c1::Tomosynthesis}}-guided core biopsy is preferred for the biopsy of asymmetries, focal asymmetries, or archit…
New Card	05/02/2023	Breast Imaging: Breast InterventionsMRI-guided breast biopsy is the preferred method for lesions seen only {{c1::on MRI}}.
New Card	05/02/2023	Breast Imaging: Breast InterventionsPrior to proceeding with MRI-guided biopsy, it is reasonable to pursue a {{c1::"second-look ultrasound"}} giv…
New Card	05/02/2023	Breast Imaging: Breast Interventions MRI-guided breast biopsy {{c1::almost always::does/does not}} require intravenous gadolinium.
New Card	05/02/2023	Breast Imaging: Breast Interventions Prior to {{c2::excisional biopsy}} or {{c3::lumpectomy}}, pre-operative localization of a breast lesion can b…
New Card	05/02/2023	Breast Imaging: Breast Interventions In radioactive seed localization (RSL), the radioactive seed can be placed up to {{c1::5 days}} before surger…
New Card	05/02/2023	Breast Imaging: Breast Interventions Radioseeds {{c1::cannot::can/cannot}} be placed under {{c2::MRI}} guidance.
New Card	05/02/2023	Breast Imaging: Breast Interventions The two methods for pre-operative marking of a breast lesion are:1.) {{c1::Radioactive seed localization (RSL…
New Card	05/02/2023	Breast Imaging: Breast Interventions Pre-operative breast wire localization {{c1::can::can/cannot}} placed be under MRI guidance
New Card	05/02/2023	Breast Imaging: Breast Interventions Pre-operative breast wire localization can be placed up to {{c1::0}} days prior to surgery
New Card	05/02/2023	Breast Imaging: Breast InterventionsThe "{{c2::bracketing}}" method of wire localization is when two or more wires are placed to delineate the {{…
New Card	05/02/2023	Breast Imaging: Breast InterventionsWhen is ultrasound-guided core needle biopsy preferred method for breast intervention?Lesion is {{c1::well seen}} …
New Card	05/02/2023	Breast Imaging: Breast InterventionsUltrasound-guided biopsy using standard {{c1::freehand}} technique and a {{c2::14}}-gauge {{c3::spring-loaded}} ne…
New Card	05/02/2023	Breast Imaging: Breast InterventionsA standard breast biopsy needle advances approximately {{c1::2}} cm when sampling
New Card	05/02/2023	Breast Imaging: Breast InterventionsIn ultrasound-guided biopsy of posterior breast lesions, enter the tip and {{c1::lift anteriorly}} off t…
New Card	05/02/2023	Breast Imaging: Breast InterventionsIn ultrasound-guided biopsy of posterior breast lesions, a {{c1::larger::smaller or larger?}} distance b…
New Card	05/02/2023	Breast Imaging: Breast InterventionsAfter adequate sampling in ultrasound-guided breast biopsy, a {{c1::tissue marker}} is placed and post-procedure {…
New Card	05/02/2023	Breast Imaging: Breast InterventionsRegardless of method of biopsy, the radiologist must perform a {{c1::radiology}}-{{c1::pathology}} correlation to …
New Card	05/02/2023	Breast Imaging: Breast InterventionsAfter breast biopsy, if pathologic results are {{c1::discordant}} with imaging, this warrants further work-up…
New Card	05/02/2023	Breast Imaging: Breast InterventionsAn example of a {{c1::discordant}} finding is benign pathology (ie fibroadenoma) for a highly suspicious, spiculat…
New Card	05/02/2023	Breast Imaging: Breast InterventionsCase: Suspicious finding on mammogram, pre-procedure ultrasound (left), post-core needle biopsy ultrasound (r…
New Card	05/02/2023	Breast Imaging: Breast InterventionsThe technique for ultrasound-guided breast {{c1::cyst}} aspiration is similar to that of a core needle biopsy, but…
New Card	05/02/2023	Breast Imaging: Breast InterventionsBreast cyst aspirate can be discarded if is {{c1::green}}, {{c2::grey}}, {{c3::yellow}} or {{c4::cloudy}}.
New Card	05/02/2023	Breast Imaging: Breast InterventionsWhich types of breast cysts should be aspirated?{{c1::Benign::Benign or Complex?}}
New Card	05/02/2023	Breast Imaging: Breast InterventionsIn what situations are stereotactic-guided biopsies performed for lesions that are NOT breast calcifications?‒ Les…
New Card	05/02/2023	Breast Imaging: Breast InterventionsStereotactic biopsy tables are situated either {{c1::prone}} or {{c1::seated upright}}.
New Card	05/02/2023	Breast Imaging: Breast InterventionsThe advantage to stereotactic biopsy in the prone position is eliminating risk of {{c1::vasovagal syncope}}.
New Card	05/02/2023	Breast Imaging: Breast InterventionsThe advantage to stereotactic biopsy in the upright seated position is it is less {{c1::expens…
New Card	05/02/2023	Breast Imaging: Breast InterventionsIn stereotactic biopsy, the breast is immobilized in {{c1::compression}} during the entire procedure.
New Card	05/02/2023	Breast Imaging: Breast InterventionsIn stereotactic-guided biopsy, paired stereo spot views of the target are obtained {{c1::15}} degrees to each side…
New Card	05/02/2023	Breast Imaging: Breast InterventionsIn stereotactic-guided biopsy, after paired stereo views of the target are obtained and {{c2::confirmed}} by radio…
New Card	05/02/2023	Breast Imaging: Breast InterventionsIn stereotactic-guided biopsy, after local anesthesia administered, a {{c1::vacuum}}-assisted biopsy needle ({{c2:…
New Card	05/02/2023	Breast Imaging: Breast InterventionsIn stereotactic-guided biopsy, after needle employed, positioning must be confirmed in the {{c1::horizontal (x), v…
New Card	05/02/2023	Breast Imaging: Breast InterventionsIn stereotactic-guided biopsy, after the samples are collected, the {{c1::specimen}} must be {{c2::radiographed}} …
New Card	05/02/2023	Breast Imaging: Breast InterventionsIn stereotactic-guided biopsy, once presence of calcifications confirmed in sample, a {{c1::marker clip}} is place…
New Card	05/02/2023	Breast Imaging: Breast InterventionsIn stereotactic-guided biopsy, correct position of the marker clip post-biopsy is essential if the lesion requires…
New Card	05/02/2023	Breast Imaging: Breast InterventionsCompared to 2D mammography-guided stereotactic biopsy, tomosynthesis-guided core biopsy has advantages o…
New Card	05/02/2023	Breast Imaging: Breast InterventionsWhat is a disadvantage of tomosynthesis-guided biopsy that may require conversion to 2D mammography-guided stereot…
New Card	05/02/2023	Breast Imaging: Breast InterventionsWhat is the only difference in steps between tomosynthesis-guided core biopsy vs 2D mammography-guided stereotacti…
New Card	05/02/2023	Breast Imaging: Breast InterventionsCase: Stereotactic biopsyTop images: Paired {{c1::15}} degrees {{c2::oblique}} pre-fire images Yell…
New Card	05/02/2023	Breast Imaging: Breast InterventionsCase: MRI-guided breast biopsy, patient positioned {{c3::prone}}Left image: {{c2::Post}}-contrast throug…
New Card	05/02/2023	Breast Imaging: Breast InterventionsAfter a lesion is discovered on MRI, second-look ultrasound may be able to target the lesion {{c1::56-57}}% of the…
New Card	05/02/2023	Breast Imaging: Breast InterventionsWhy is it important to perform MRI-guided biopsy as quickly as possible?Lesion must be targeted before {{c1::contr…
New Card	05/02/2023	Breast Imaging: Breast InterventionsThe {{c1::grid-coordinate}} method allows accurate biopsy of breast abnormality seen only on MRI, analogous to CT-…
New Card	05/02/2023	Breast Imaging: Breast InterventionsIn MRI-guided biopsy, it is preferred to apply the grid {{c1::laterally::medially or laterally}} for approach, bec…
New Card	05/02/2023	Breast Imaging: Breast InterventionsIn MRI-guided biopsy, after the targeted lesion is localized on the grid and local anesthesia administered, core n…
New Card	05/02/2023	Breast Imaging: Breast InterventionsIn MRI-guided biopsy, multiple {{c1::9}}- to {{c1::11}}-gauge {{c2::vacuum}}-assisted samples are obtained and pos…
New Card	05/02/2023	Breast Imaging: Breast InterventionsRadioactive seed localization is performed with a{{c1::n iodine-125}} radioactive seed.
New Card	05/02/2023	Breast Imaging: Breast InterventionsRadioactive seeds are placed pre-operatively under either {{c1::mammographic}} or {{c1::ultrasound}} guidance, wit…
New Card	05/02/2023	Breast Imaging: Breast InterventionsIn the operating room, radioactive seeds are detected with a {{c1::gamma probe}} prior to excision.
New Card	05/02/2023	Breast Imaging: Breast InterventionsAdvantages of radioactive seeds over wire localization for breast surgery include:‒ More flexibility in {{c1::appr…
New Card	05/02/2023	Breast Imaging: Breast InterventionsWhy can't radioseeds be placed under MRI-guidance?{{c1::Pre-loaded needles}} and {{c2::gamma probes}} are MRI inco…
New Card	05/02/2023	Breast Imaging: Breast InterventionsDisadvantages of radioactive seeds over wire localization for breast surgery include:‒ Implementing {{c1::saf…
New Card	05/02/2023	Breast Imaging: Breast InterventionsIn pre-operative wire localization, {{c1::shortest::shortest or longest}} approach to the lesion should be used, w…
New Card	05/02/2023	Breast Imaging: Breast InterventionsWith pre-operative wire localization, after lumpectomy/excisional biopsy, specimen {{c1::radiographs}} confirm {{c…
New Card	05/02/2023	Breast Imaging: Breast InterventionsCase: Steps in Mammographic Wire LocalizationStep 1 (top left): Alphanumeric grid assists with localizat…
New Card	05/02/2023	Breast Imaging: Breast InterventionsNewer methods for pre-operative localization of breast lesions include {{c1::non-magnetic}} {{c1::radioactive}} ra…
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