Benign and Malignant Diseases of the Breast

Question 1

What is a galactocele and what is this lesion generally associated with?

Answer 1

A milk filled cyst with a high fat content. It is associated with lactation.

Question 2

Peau d’ orange describes what type of breast?

Answer 2

Breast where the skin is thicker than normal-described as skin thickening syndrome.

Question 3

Describe why a mass density is seen more clearly on fatty rather than dense breast tissue.

Answer 3

Fatty tissue is seen as dark areas on the radiograph, while dense breast tissue, which represents fibroglandular areas, is seen as white. Lesions are also seen as white, which makes them difficult to discern in dense breast tissue.

Question 4

The term reduction mammoplasty refers to what?

Answer 4

A technique used to reduce the overall size of the breast for cosmetic or medical reasons.

Question 5

The halo is significant in the analysis of a mass on the mammogram. Describe it’s significance.

Answer 5

The halo is a complete or partial radiolucent ring seen predominately around circular or oval lesions. Typically, circular or oval lesions are benign however the content of any lesion must be assessed.

Question 6

Ultrasound and MRI are especially important in diagnosing what types of implant problems

Answer 6

Implant rupture or leaks

Question 7

Describe and give an example of a radiolucent lesion.

Answer 7

If the lesion is radiolucent, the breast parenchyma is visible through the lesion. An example is a cyst.

Question 8

Give three mammography characteristics of a benign circular lesion.

Answer 8

Radiolucent, and radiopaque, low-density, halo sign, capsule, spherical or oval, smooth borders.

Question 9

Give three ultrasound characteristics of a benign oval lesion.

Answer 9

Hyperechogenic, ellipsoid shape, the capsule, compressibility, acoustic shodowing.

Question 10

Spicules from a lesion in the breast can cause what changes if it reaches the breast skin?

Answer 10

Dimpling or skin thickening syndrome.

Question 11

What is the significance of asymmetric breast tissue?

Answer 11

Could indicate a malignancy, especially if seen in the posterior aspect of post menopausal women. The breast structure should be a mirror image of both sides.

Question 12

Give two mammographic and sonographic characteristics of malignant speculated lesions.

Answer 12

a. Mammography characteristics: Distinct central mass, sharp dense line radiating in all directions from the central mass, dimpling or skin thickening if the spicules reach the skin, can be associated with malignant type calcifications.
b. Ultrasound characteristics: Speculated outline, taller than wide, shadowing, ductal extension pattern, microlobulations

Question 13

Describe four characteristics of benign calcification.

Answer 13

Smooth borders, high uniform density, evenly scattered, sharply outlined, spherical or oval, teacup density on the ML, ring-like, eggshell-like, large bizarre size

Question 14

What are the six important factors used to analyze breast calicifications?

Answer 14

Calcifications can be analyzed for density, distribution, change over time, number, morphology and size.

Question 15

What are the two main classifications o f breast cancer?

Answer 15

Ductal and lobular carcinoma

Question 16

Reduction mammoplasty often involves:

Answer 16

Reduction mammoplasty reduces the overall size of the breast. In general, all breast reduction will involve the relocation of the nipple.

Question 17

A patient with beau d’orange type breast will present:

Answer 17

Peau d’orange describes a thickening of the skin of the entire breast. Skin thickening can be caused by benign conditions or malignant disease.

Question 18

Benign breast calcifications include all of the following except;

Answer 18

Casting type calcifications are produced when ductal carcinoma in situ fills the ducts. The Calcifications are the result of cell necrosis at the center of the growth.
Milk of calcium forms in the lobules as a result of calcified debris. Plasma cell mastitis is the result of increased cellular activity and vascular calcifications are calcified arteries or veins.

Question 19

Which of the following describes the characteristics of benign circular or oval lesions?

Answer 19

Radiolucent, halo sign, low density

Question 20

Asymmetric breast tissue-seen as an area on one mammogram that is not reproduced on the other-referred to as:

Answer 20

Architectural distortion represents areas of increased density on one breast that is not mirrored on the other side. The cause can be benign or malignant. Stellate lesion or speculated lesions often represents malignancy.

Question 21

The halo sign is often used to identify:

Answer 21

The halo often will surround oval or circular lesions. These lesions are often benign. However, a circular or oval lesion can hold a cancer within the lesion itself. In any evaluation, the content of the circular or oval lesion must be checked.

Question 22

Oil cyst are:

Answer 22

Oil cysts are benign eggshell-like calcifications.

Question 23

The two most common types of breast cancer are:

Answer 23

Ductal and lobular carcinoma are the two most common types of breast cancer. Metastasis refers to the spread of cancer beyond the breast.

Question 24

which of the following lesions are likely to be malignant?

Answer 24

Benign lesions are often circular, oval with few lobulations. Cancerous lesions are often speculated, multiple lobulated, and high density.

Question 25

A fibroadenoma is a:

Answer 25

Fibroadenomas are formed from stromal and epithelial elements. Although they are most often benign, a cancer can grow with a fibroadenoma.

Question 26

Breast cancer stages

Stage I

Answer 26

Tumor no larger than 2cm that has not spread

Question 27

Breast cancer stages

Stage 0

Answer 27

In situ carcinoma, lobular carcinoma or Paget’s disease of the nipple with no tumor

Question 28

Breast cancer stages

Stage II

Answer 28

Tumor no larger than 2cm that has not spread to lymph node
Or
Tumor between 2 and 5 cm’s that may or may not have spread to lymph nodes
Or
Tumor larger than 5 cm’s but has not spread to the lymph nodes

Question 29

Breast cancer stages

Stage III

Answer 29

A tumor is smaller than 5cm’s and has spread to multiple lymph nodes

Tumor has spread to tissue near the breast and/or lymph nodes near the clavicle

Question 30

Breast cancer stages

Stage IV

Answer 30

Includes inflammatory Br Ca or a tumor that has already spread to the other organs such as bones, lungs, or liver

Question 31

The sentinel node is:

Answer 31

The first lymph node into which the tumor drains and is located in the Scilla

Question 32

A fibroadenoma is :

Answer 32

The most common mass in women under 25

Question 33

A benign condition that often occurs in women who abruptly stop breast feeding is called?

Answer 33

Galactic eke

Question 34

A key feature of inflammatory breast cancer is that:

Answer 34

The inflammation does not go away. The area is hot, red, painful and does not get better

Question 35

In breast cancer today the most common method of discovery is:

Answer 35

A mammographic abnormality with no physical symptoms reported by the patient.

Question 36

A modified mastectomy includes the removal of the entire breast and some scull art nodes:

True or false

Answer 36

True

Question 37

A breast cancer begins to grow ___years before is mammographic ally visible and __ years before its palpable?

Answer 37

8 and 10

Question 38

Poky mastic

Answer 38

Extra nipple(s)

Question 39

A calcification that lacks apparent shape or organization is described as:

Answer 39

Amorphous

Question 40

TNM breast cancer staging

Answer 40

T= breast tumor size
N = palpable lymph nodes 
M = metastasis

Question 41

Three main types of invasive breast cancer:

Answer 41

Inflammatory
Ducatal -most common
Lobular-2nd most common

Question 42

Two types of non invasive breast cancer

Answer 42

LCIS, lobular carcinoma in situ

DCIS, ducal carcinoma in situ (appears as microcalcifications)