AB-Breast and prostate Flashcards
normal prostate measurements
2x4x3
What is a common abnormality that they undergo?
BPH; Benign prostate hypertrophy
what lab test is done … and if it’s elevated, what does that usually mean?
PSA (blood test) An Increased # of prostate cells that increased over 50% from normal amount can result in cancer.
malignant cells usually lie in what lobe?
periphery
What is the functional portion of breast? ..and how many lobes are there?
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.
Echogenicity of retromammary region
similar in echogenicity and echotexture to the subcutaneous layer. fatty tissue appears hypoechoic, and the ducts, glands, and supporting ligaments appear echogenic
Characteristics of a papilloma
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.
Arterial supply to the breast
main arterial supply to the breast comes from the internal mammary and the lateral thoracic arteries
What are structures in the breast, called the fibrous skeleton, that help maintain the shape made up of?
Cooper’s ligaments pg. 551
As a woman ages, glandular tissue in the breast is replaced by ___.
Fatty tissue pg. 553
What are the characteristics of Cooper’s ligaments?
Sonographic characteristics are echogenic and are dispersed in a linear pattern. Best identified when beam strikes the ligaments at a perpendicular angle. pg 552
If a woman comes to you, and she has lumpy, bumpy, painful, tender breasts, what does she have?
fibrocystic breasts
What is the most common benign tumor of the breast?
Fibroadenoma , they occur primarily in young women pg. 575
What is the most common malignant tumor of the breast?
Scirrhous Carcinoma pg. 581 Invasive Ductal Carcinoma (IDC) Per Beth’s power point….
Skin dimpling is a sign of ___.
breast cancer pg 571
What is the primary purpose of breast screening?
The detection and diagnosis of breast cancer in its earliest and most curable stage pg. 559
The American Cancer Society states women should have a mammogram by age ___.
40 pg. 559
What is it called when a male has big breasts?
Gynecomastia pg. 556
What are the sonographic signs of breast cancer?
- 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
When mammography sees microcalcifications, ultrasound does not identify them. This is not a reason to do a biopsy.
~
What are some good reasons to do a breast ultrasound?
- 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
Benign lesions
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
Malignant Lesions
• 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
Simple cyst vs Complex cyst
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
What are the 3 layers of the breast?
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
Abnormality/normal finding, normal breast tissue goes into the axial region-what is it called?
Tail of Spence
Advantages of breast ultrasound over breast mammography
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
Breast cancer screening
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
