BRCA-Associated Cancers: Role of Imaging

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification for enrollments starting after January 30, 2024:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Breast Sonography: 1.50
Patient Care: 1.00
Patient Interactions and Management: 1.00
Procedures: 0.50
Pathology: 0.50

Computed Tomography: 1.00
Procedures: 1.00
Abdomen and Pelvis: 1.00

Mammography: 1.75
Patient Care: 0.50
Patient Interactions and Management: 0.50
Procedures: 1.25
Anatomy, Physiology, and Pathology: 0.75
Mammographic Positioning, Special Needs, and Imaging Procedures: 0.50

Magnetic Resonance Imaging: 1.50
Procedures: 1.50
Body: 1.50

Nuclear Medicine Technology: 0.50
Procedures: 0.50
Endocrine and Oncology Procedures: 0.50

Registered Radiologist Assistant: 3.00
Procedures: 3.00
Abdominal Section: 1.25
Thoracic Section: 1.75

Sonography: 1.00
Procedures: 1.00
Abdomen: 0.25
Gynecology: 0.25
Superficial Structures and Other Sonographic Procedures: 0.50

Radiation Therapy: 3.00
Patient Care: 1.50
Patient and Medical Record Management: 1.50
Procedures: 1.50
Treatment Sites and Tumors: 1.50

Outline

1. Introduction
2. Breast Cancer
   1. Pathologic Features
   2. Role of Imaging
      1. Mammography
      2. Ultrasonography
      3. MR Imaging
   3. Cancer Staging
   4. Screening Guidelines
   5. Male Breast Cancer
   6. Management
3. Extrauterine Pelvic Serous Carcinomas
   1. Ovarian Cancer
   2. PFTC and PPSC
4. Pancreatic Cancer
5. Prostate Cancer
6. Colorectal Cancer
7. Conclusion

Objectives

Upon completion of this course, students will:

1. name the chromosomes where BRCA1 and BRCA2 suppressor genes are located
2. recall the number of BRCA gene mutations
3. list the risk factors associated with the BRCA genome
4. state the pattern of transmission for the BRCA gene mutation
5. know the chance that first-degree relatives of BRCA mutation carriers also may be carriers of the mutated gene
6. state how imaging contributes to helping patients with BRCA mutations
7. list factors that help provide a definitive diagnosis for BRCA mutations
8. recall the number of women estimated to be diagnosed with breast cancer in 2016
9. express the estimated percentage of female BRCA2 mutation carriers that will develop breast cancer by age 70
10. list the phenotypes of breast cancer that help identify individuals that carry germ line mutations of the BRCA genes
11. state the median age of breast cancer diagnosis for BRCA carriers
12. recall the percentage invasive ductal carcinomas in BRCA mutations carriers
13. state the type of breast cancer that is almost never identified in BRCA1 mutation carriers
14. define the “triple negative”
15. recall the sensitivity of mammography for the detection of breast cancer in BRCA mutation carriers
16. describe the growth rate and lead time for BRCA-associated breast cancers
17. determine the most accurate type of mammography for young women with dense breast tissue
18. list the mammographic findings that best detect a malignant lesion
19. state the most commonly described mammographic feature of BRCA-associated breast cancers
20. recall the study reporting that breast lesions in BRCA mutation carriers were more often round with sharp well-defined margins as compared with malignant lesions in a matched sporadic control group
21. describe the shape of medullary breast cancers in BRCA1 mutation carriers
22. identify the study that concluded that ALL mammographically detected lesions should be further evaluated with ultrasound and biopsy
23. state the ultrasound appearance of BRCA-associated breast cancers
24. state the imaging modality used for breast cancer screening for high risk women who have contraindications to magnetic resonance imaging
25. express the sensitivity and specificity of breast magnetic resonance imaging
26. identify the screening trial that compared annual MR imaging with annual mammography and the sensitivity of each
27. document the combined imaging modalities currently recommended for screening BRCA mutation carriers
28. state the fraction of BRCA mutation carriers with stage IV cancer that will develop brain metastases
29. recall what type of metastases is rare in BRCA2 mutation carriers
30. state the age at which breast awareness measures should begin for women with BRCA mutations
31. express the risk reduction for breast cancer experienced by BRCA mutation carriers who undergo prophylactic mastectomy
32. state the median age for BRCA-associated male breast cancer diagnosis
33. state the age that men with BRCA mutations should begin breast self-examination
34. know the percentage of women with a BRCA2 mutation that may develop ovarian cancer by age 70
35. list the conditions commonly associated with high grade serous carcinomas
36. list the similarities between PFTC, PPSC, and serous ovarian carcinoma
37. distinguish between relative risk for PDAC in BRCA-mutation carriers and those in the general population
38. recall the approved version of the Prostate Imaging Reporting and Data Systems guidelines
39. state the most common histologic subtype of colon cancer in BRCA1 mutation carriers
40. express the imaging examination of choice for evaluating patients with colon adenocarcinoma