Mock Oral Boards

What do you want to do?

Last Year

Last Year

What next?

What is this?

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

Image from UofWash Teaching File

Image from UofWash Teaching File

Image from UofWash Teaching File

Case 2 Keys DDx for a fat-containing lesion

(hamar toma, lipoma, oil cyst, galactocele)

Final diagnosis = hamar toma

What do you want to do?

Impression?

Case 3 Keys Workup for a focal asymmetry

(lateral, spot compression and ultrasound)

BIRADS 4: Suspicious finding (IDC)

What do you want to do?

Impression?

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)

Right Axilla

Right Axilla

Impression?

Case 5 Keys Differential diagnosis for bilateral adenopathy

Lymphoma

Rheumatoid / Autoimmune

Granulomatous / Sarcoid

Systemic processes

Metastatic disease (less likely unless diffuse mets)

Milk of Calcium BIRADS 2: Benign finding

(layering on the ML view)

What do you want to do?

Impression?

Does this change anything?

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.

Any questions?

Impression?

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

Case 8 Keys

Intra- and extra-capsular silicone implant rupture

- linguine sign

- free silicone

Impression?

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

Impression?

Case 10 Keys Linear non-masslike enhancement in the central right

breast is suspicious

BIRADS 4: MRI guided biopsy is recommended

What do you want to do?

What next?

Ultrasound is negative, what do you do?

What is this?

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

Case 12 Keys Aunt Minnie appearance:

Neurofibromatosis

- multiple superficial round masses

- nipple deformity

Good Luck!