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Immersive and self-explanatory content to succeed in NEET-SS - Surgery

Rapid Acquisition Of Key Concepts - Breast And Endocrine

Apr 11, 2024

American Thyroid Association Sonographic Patterns and Estimated Risk of Malignancy for Thyroid Nodules

SONOGRAPHIC PATTERN	SONOGRAPHIC FEATURES	ESTIMATED RISK OF MALIGNANCY	CONSIDER BIOPSY
High Suspicion	Solid hypoechoic nodule or solid hypoechoic component of a partially cystic nodule with one or more of the following features: irregular margins (infiltrative, micro lobulated), microcalcifications, taller than wide shape, rim calcifications with small extrusive soft tissue component, evidence of extrathyroidal extension	> 70-90	≥ 1 cm
Intermediate suspicion	Hypoechoic solid nodule with smooth margins without micro calcifications, extrathyroidal extension, or taller than wide shape	10-20	≥ 1 cm
Low suspicion	Isoechoic or hyperechoic solid nodule or partially cystic nodule with eccentric solid areas without microcalcification, irregular margin or extrathyroidal extension, of taller than wide shape	5-10	≥ 1.5 cm
Very low suspicion	Spongiform or partially cystic nodules without any of the sonographic features described in low, intermediate, or high suspicion patterns	<3	≥ 2 cm
Benign	Purely cystic nodules (no solid component)	<1	No Biopsy

Also Read: Thyroid, Parathyroid And Adrenal Image Based Question

Breast Imaging Reporting And Database System (BI-RADS)

Breast imaging reporting and Database System (BI-RADS)
Category	Assessment	Probability of malignancy	Follow-up recommendation
0	Assessment in incomplete	Not applicable	Need for additional imaging evaluation and/or prior mammograms of comparison
1	Negative	Essentially 0%	Routine annaul screening mammography (for women over age 40)
2	Beningn finding(s)	Essentially 0%	Routine annaul screening mammography (for women over age 40)
3	Probably benign finding	>0% but ≤ 2%	Initial short-term follow up (Usually 6 months) examination
4	Suspicious abnormality 4a: Finding needing intervention with a low suspicion for malignancy 4b: Intermediate suspicion of malignancy 4c: Findings of moderate concern, with high suspicion of malignancy	>2 to ≤ 10% >10 to ≤ 50% >50% to < 95%	Biopsy should be considered
5	Highly suggestive of malignancy	≥ 95%	Requires biopsy or surgical treatment
6	Know biopsy – proven malignancy	Not applicable	Category reserved for lesions identified on imaging study with biopsy proof of malignancy prior to definitive therapy

Also Read: High-Yield NEET SS Surgery Breast and Endocrine Questions

Classification of Breast Ductal Carcinoma In situ

	Determining Characteristics
Histologic Subtype	Nuclear Grade	Necrosis	DCIS Grade
Comedo	High	Extensive	High
Intermediate	Intermediate	Focal or Absent	Intermediate
Non comedo	Low	Absent	Low

Also Read: Prune Belly Syndrome (Eagle Belly Syndrome)

Tirads Reporting System

COMPOSITION

(Choose 1)

Cystic 0

Spongiform 0

Mixed cystic and solid 1

Solid 2

ECHOGENICITY

(Choose 1)

Anechoic 0

Hyperechoic or Isoechoic 1

Hypoechoic 2

Very Hypoechoic 3

SHAPE (Choose 1)

Wider-than tall 0

Taller-than-wide 3

MARGIN

(Choose 1)

Smooth 0

Ill-defined 0

Lobulated or irregular 2

Extra-thyroidal extension 3

ECHOGENIC FOCI

(Choose All that Apply

None or large comet-tail artifacts

Macrocalcifications

Peripheral (rim) calcifications

Punctate echogenic foci

Add Points For TI-RADS level

0 Point

2 Points

3 Points

4 or 6 Points

7 Points or more

TR1

Benign

No FNA

TR2

Not Suspicious

No FNA

TR3

Mildly Suspicious

FNA if > 2.4 cm

Follow if > 1.5 cm

TR4

Moderately Suspicious

FNA if > 1.5 cm

Follow if > 1 cm

TR5

Highly suspicious

FNA if > 1 cm

Follow if > 0.5 cm

American Thyroid Association Sonographic Patterns and Estimated Risk of Malignancy for Thyroid Nodules

SONOGRAPHIC PATTERN	SONOGRAPHIC FEATURES	ESTIMATED RISK OF MALIGNANCY	CONSIDER BIOPSY
High Suspicion	Solid hypoechoic nodule or solid hypoechoic component of a partially cystic nodule with one or more of the following features: irregular margins (infiltrative, micro lobulated), microcalcifications, taller than wide shape, rim calcifications with small extrusive soft tissue component, evidence of extrathyroidal extension	> 70-90	≥ 1 cm
Intermediate suspicion	Hypoechoic solid nodule with smooth margins without micro calcifications, extrathyroidal extension, or taller than wide shape	10-20	≥ 1 cm
Low suspicion	Isoechoic or hyperechoic solid nodule or partially cystic nodule with eccentric solid areas without microcalcification, irregular margin or extrathyroidal extension, of taller than wide shape	5-10	≥ 1.5 cm
Very low suspicion	Spongiform or partially cystic nodules without any of the sonographic features described in low, intermediate, or high suspicion patterns	<3	≥ 2 cm
Benign	Purely cystic nodules (no solid component)	<1	No Biopsy

Hope you found this blog helpful for your NEET SS Surgery Breast and endocrine preparation. For more informative and interesting posts like these, keep reading PrepLadder’s blogs.

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