Real-time anomaly segmentation demands both high recall and efficient low-precision inference. We study the three-way interaction of model architecture, model scale, and FP4 quantization-aware training (QAT) recipe on a recall-critical brain tumor segmentation task, evaluating multiple architectures, scales, and QAT recipes under a unified protocol. We find that architecture choice has the largest impact on quantization robustness, with attention-based architectures showing remarkable resilience to recipe choice while CNN degrades under gradient-quantizing recipes at larger scales. At low capacity, FP4 can discretize softmax attention, but advanced QAT recipes prevent this collapse. At larger scales, advanced recipes mitigate gradient quantization noise that degrades CNN quality. Five-fold patient-level cross-validation confirms these findings are robust to data partition. Our results show that the Swin Transformer is robust to QAT recipe choice across all scales, making it the recommended architecture for FP4-quantized anomaly segmentation.