abdomen scrotum and breast reveiw Flashcards
three layers of the breast
located b/w the skin and pectorlias major muscle:
subcutaneous layer, the mammary (glandular layer and the retromammary layer
subcutaneous layer: thin
fatty tisssue
coopers lig
mammary layer:functional part 15-20 lobes rad from nipple laciferous ducts carry milk from acini to the nipple terminal ductl lobular unit (TDLU) is made up of acini and terminal ducts fatty tissue is interspersed bw lobes coopers lig extend from retro fascia to the skin to provide support Retromammary layer: thin fatty tissue coopers lig pect major mucle pectorlis min ribs chest wall
the functional portion of the breast (mammary/glandular layer)consist of how many lobes?
15-20 lobes
fibrous skeleton is responsible for maintaining the shape of the breast?
coopers ligaments!
but..
spaces bw the lobes is filled with connective and fatty tissue known a stroma.
as a women ages gandular breast tissue is replaced with what
tissue undergoes cell death and is remodeled by the infatuating of fatty tissue.
ducts atrophy
fatty breast hard to sono bc breast cancer hypo and so is breast fat
What coopers ligament looks like under ultrasound
coopers lig and other connective tissue appear echogenic and are dispersed in a linear pattern
C.L best identified when the beam strikes them at a perpendicular angle, compression of the breast often enhances the ability to visualize them
Sonographic texture of the retromammary layer:
similar in echogenicity and echotexturre to the subcutaneous lay although the boundary echoes resemble skin reflections . pec major mus appear as low-level echo areas posterior to the retromammay layer. ribs are hyper echoic rounded structures
most important signs that a lesion is cystic
oval or round, anechoic, imperceptible capsule, posterior or acoustic enhancement, edge refraction shadowing, often compressible
if patient has clinicals signs of lumpy, bumpy, tender breast with their monthy cycle, what kind of breast disease do they have?
fibrocystic condition( fibrocystic change/ fibrocystic disese)
lumps and pain that patient feels that fluctuate with every monthly cycle. usually both breast.
sono: round masses as multiple cysts.
What are the characteristic of a papilloma
intraductal papilloma is small, benign tumor that grows within the acini.
age 35-55
symptom:
nipple discharge from a single duct
sensation of fullness or pain in the areola that is relieved by fluid being expelled
mamo” raspberry like
sono: usually small, muli and multicentric. supported by a vasular stalk from which it receves blood
- arise from lining of breast ducts, retroareolar area most common
Bloody discharge from single duct
Sonographic findings
Tiny papilloma may not be detected
May cause dilatation of a single duct
Intracystic papillomas- soft tissue mass growing into lumen of cystic lesion
most common solid benign tumor of the breast?
benign fibroadenoma
sono:
oval or gentaly lobular, hypoechogenic, uniform echogenicity, smooth, distinct margins, wider than tall, posterior acoustic enhancement, edge refraction shadow
stimulated by estrogen
firm, rubbery, freely mobile and clearly delineate from the surrounding tissue
lymphatic drainage where?
lymphatic drainage from all parts of the breast generally flows to the axillary lymph nodes
from superfical to deep nodes of the breast centrifugally toward the axillary and interal lymph node chains only 3% eliminated by the interal and 97% by axillary chain
most common malignant neoplasam of the breast?
Invasive ductal carcinoma-IDC
Extension past duct and into stroma
Most common malignancy
Hard fixed mass
Skin dimpling or skin/nipple retraction
Mammography findings: Asymmetric Radiopaque speculated mass Microcalcifications Thickened and retracted Cooper’s ligament
Sonographic findings: Solid mass Hypoechoic Heterogeneous Taller than wide orientation Distal acoustic shadowing Possible- microlobulations, microcalcification, ductal extension branch pattern, fascial plane disruption
describe the characteristics of breast carcinoma
margins: indistinct, fuzzy, spiculated
architecture: grow through tissue without compression of the tissue adjacent to the mass
may cause retraction of nipple or skin dimpling
shape: sharp, angular microlobulations > or =3
taller than wide, radial growth suspicious,
echo: hyperechoic, weak internal echoes, clustered microcalcifications.
strong attenuating
firmly fixed
rigid, noncompressible
hypervscular, feeder
ves.ssels
skin dimpling suggestive of what?
Invasive ductal carcinoma-IDC
Papillary
most common clinical sign of breast cancer?
70% of cancers found as lumps felt during Beast self-exam or clinical breast exam
Primary purpose of breast screening?
?
know your clock.
.
normal extension of breast tissue into the axillary region.
tail of spence
according to the american cancer society all women should begin annual mammogram screening at what age?
40
which one of the following arteries is responsible for supplying blood to more than 1/2 of the breast?
more than 1/2 of breast (mainly central and medial part) supplied by the anterior perforating branches of the internal mammary artery
remaining portion (upper outer quad) supplied by the lateral thoracic artery
