AB-Breast and prostate

Question 1

normal prostate measurements

Answer 1

2x4x3

Question 2

What is a common abnormality that they undergo?

Answer 2

BPH; Benign prostate hypertrophy

Question 3

what lab test is done … and if it’s elevated, what does that usually mean?

Answer 3

PSA (blood test) An Increased # of prostate cells that increased over 50% from normal amount can result in cancer.

Question 4

malignant cells usually lie in what lobe?

Answer 4

periphery

Question 5

What is the functional portion of breast? ..and how many lobes are there?

Answer 5

The mammary/glandular layer includes the functional portion of the breast. Functional portion is made up of 15 to 20 lobes, which contain that milk producing glands, and the ductal system, which carries milk to the nipple.

Question 6

Echogenicity of retromammary region

Answer 6

similar in echogenicity and echotexture to the subcutaneous layer. fatty tissue appears hypoechoic, and the ducts, glands, and supporting ligaments appear echogenic

Question 7

Characteristics of a papilloma

Answer 7

benign, arise from lining of breast ducts, retroareolar area most common, blood discharge. Sonographic findings- tiny papilloma may not be detected, may cause dilation of a single duct. Intracystic papillomas- soft tissue mass growing into lumen of cystic lesion.

Question 8

Arterial supply to the breast

Answer 8

main arterial supply to the breast comes from the internal mammary and the lateral thoracic arteries

Question 9

What are structures in the breast, called the fibrous skeleton, that help maintain the shape made up of?

Answer 9

Cooper’s ligaments pg. 551

Question 10

As a woman ages, glandular tissue in the breast is replaced by ___.

Answer 10

Fatty tissue pg. 553

Question 11

What are the characteristics of Cooper’s ligaments?

Answer 11

Sonographic characteristics are echogenic and are dispersed in a linear pattern. Best identified when beam strikes the ligaments at a perpendicular angle. pg 552

Question 12

If a woman comes to you, and she has lumpy, bumpy, painful, tender breasts, what does she have?

Answer 12

fibrocystic breasts

Question 13

What is the most common benign tumor of the breast?

Answer 13

Fibroadenoma , they occur primarily in young women pg. 575

Question 14

What is the most common malignant tumor of the breast?

Answer 14

Scirrhous Carcinoma pg. 581 Invasive Ductal Carcinoma (IDC) Per Beth’s power point….

Question 15

Skin dimpling is a sign of ___.

Answer 15

breast cancer pg 571

Question 16

What is the primary purpose of breast screening?

Answer 16

The detection and diagnosis of breast cancer in its earliest and most curable stage pg. 559

Question 17

The American Cancer Society states women should have a mammogram by age ___.

Answer 17

40 pg. 559

Question 18

What is it called when a male has big breasts?

Answer 18

Gynecomastia pg. 556

Question 19

What are the sonographic signs of breast cancer?

Answer 19

1. Margins indistinct fuzzy and spiculate 2.Grow through tissue without compressing adjacent tissue and may cause retraction of nipple or skin dimpling 3. Shape sharp, angular microlobulations 4 .Orientation taller than wide, radial growth suspicious for intraductal lesions 5. Echo pattern hypoechoic, weak internal echoes, clustered microcalcifications 6. Strong attenuating 7. Mobility firmly fixed 8. Compressibility rigid noncompressible 9. Hypervascular, feeder vessel may be identified pg 571

Question 20

When mammography sees microcalcifications, ultrasound does not identify them. This is not a reason to do a biopsy.

Answer 20

~

Question 21

What are some good reasons to do a breast ultrasound?

Answer 21

1. Further characterization of mammogram mass (cystic or solid) 2. Eval of a palpable breast lump 3. Pregnant or lactating pt 4.Pt with breast augmentation 5. Difficult or compromised mammogram 6. Imaged guided procedure 7. young women pg 568

Question 22

Benign lesions

Answer 22

SMOOTH, ROUNDED MARGINS • GROW HORIZONTALLY WITHIN TISSUE
PLANES • PARALLEL TO CHEST WALL • ROUND OR OVAL SHAPE • “WIDER THAN THEY ARE TALL”• ISOECHIC WITH BREAST TISSUE • EXHIBIT POSTERIOR ENHANCEMENT • ARE MOBILE AND COMPRESSIBLE • DO NOT HAVE INCREASED BLOOD

Question 23

Malignant Lesions

Answer 23

• HAVE FINGER-LIKE PROJECTIONS CALLED SPICULATIONS
• SHARP, ANGULAR BORDERS
• CAUSE SKIN DIMPLING OR NIPPLE RETRACTION
• “TALLER THAN THEY ARE WIDE”• HYPOECHOIC • HAVE POSTERIOR SHADOWING BEHIND
LESION • RIGID & NONCOMPRESSIBLE • HAVE INCREASED VASCULARITY WITH
FEEDER VESSEL

Question 24

Simple cyst vs Complex cyst

Answer 24

Simple cyst: oval or round, anechoic, imperceptible capsule, posterior acoustic enhancement, edge refraction shadowing, often compressible
Complex cyst: irregular or thickened wall, mural nodule, fluid level, debris, particulate echoes, variable degrees of shadowing

Question 25

What are the 3 layers of the breast?

Answer 25

1.Subcutaneous layer- usually quite thin and consist of fat surrounded by connective tissue septa 2.Mammary (glandular) layer- includes the functional portion of the breast and the surrounding supportive (stromal) tissue 3.Retromammary layer- same as subcutaneous layer. All three of these layers are located between the skin and the pectoralis major muscle on the anterior of the chest wall. pg. 550

Question 26

Abnormality/normal finding, normal breast tissue goes into the axial region-what is it called?

Answer 26

Tail of Spence

Question 27

Advantages of breast ultrasound over breast mammography

Answer 27

Ultrasound young, dense breast because it is difficult to penetrate by mammography to evaluate palpable masses and to image the deep juxtathoracic tissue that are not visible by mammography. Ultrasound is also useful in differentiating structures within uniformly dense breast tissue in which mammography is limited (differentiating solid, round masses from fluid-filled cysts and in visualizing tissue adjacent to implants) p 559

Question 28

Breast cancer screening

Answer 28

Breast self-examination- monthly beginning at age 20
Clinical breast examination by a health care provider- ages 20-39, every 3 years. ages 40 on, yearly
Screening mammography-yearly starting at age 40