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Benign Breast Pathology Flashcards

1
Q

What is meant when a mass is parallel or non-parallel?

A

Parallel = wider than tall

Non-parallel = taller than wide

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2
Q

What is the most common cause of breast lumps in women and what age?

A

Cysts - ages 35-50

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3
Q

What is a common cause of breast cysts?

A

Fibrocystic change (FCC) due to the dilation of ducts when the TDLU’s are obstructed

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4
Q

What is the most common DIFFUSE breast condition?

A

FCC - fibrocystic change

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5
Q

What is the main reason for FCC?

A

Hormonal imbalance that changes features of the TDLU (terminal duct lobular unit)

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6
Q

What pathology is seen with nodular adenosis or sclerosing adenosis?

A

FCC

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7
Q

SF of FCC?

A
  1. Increased echogenicity of PARENCHYMA
  2. Tiny echogenic foci
  3. Multiple cystic areas in both breasts
  4. Nodular adenosis
  5. Sclerosing adenosis
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8
Q

What pathology shows a non-dependent echogenic layer that could be due to floating fat-fluid level?

A

Acorn cysts - move patient position to determine mobility

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9
Q

What pathology is filled with diffuse low level internal echoes and can be difficult to differentiate from solid masses?

A

Foam or gel cysts

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10
Q

What does PAM stand for?

A

Papillary apocrine metaplasia

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11
Q

What is PAM?

A

An abnormal change or growth of cells lining the ducts of the breast - NON MOBILE

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12
Q

What is the most common benign mass in lactating patient?

A

Galactocele

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13
Q

What duct is obstructed in the case of galactocele?

A

Lactiferous duct

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14
Q

What is a common location for a galactocele in the breast?

A

SUB-areolar

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15
Q

SF if galactocele?

A
  1. Round/oval
  2. Internal echoes due to milk contents
  3. Fluid-fat levels that are MOBILE
  4. Rim calcs
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16
Q

T or F? Galactoceles regress spontaneously

A

TRUE

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17
Q

What pathology are benign masses from the skin layers and are superficial?

A
  1. Sebaceous cysts
  2. Epidermal inclusion cysts
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18
Q

What may sebaceous or epidermal inclusion cysts contain? (2 substances)

A
  1. Sebum
  2. Keratin
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19
Q

What may cause sebaceous or epidermal inclusion cysts?

A

Obstructed sebaceous gland or hair follicle

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20
Q

What is the term for an inflamed breast?

A

Mastitis

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21
Q

In what population is mastitis most common?

A

Pregnant and lactating women

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22
Q

Patient symptoms of mastitis?

A
  1. Pain
  2. Swelling
  3. Nipple discharge
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23
Q

What can mastitis progress to if left untreated?

A

Abscess

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24
Q

SF of mastitis?

A
  1. Thickened walls
  2. Edema
  3. Vascularity surrounding ducts
  4. Dilated infected ducts
  5. Possible calcifications
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25
What is the most common location of an abscess in the breast?
Sub-areolar
26
Patient symptoms of breast abscess?
1. Elevated WBC 2. Tender/palpable 3. Inflammation (mastitis) 4. Pain
27
SF of a breast abscess?
1. Thickened, edematous walls 2. Complex fluid collection with internal echoes 3. Possible air contained within 4. Vascularity SURROUNDING abscess
28
Common treatment for an abscess?
IV antibiotics
29
What benign pathology can occur in both males or females?
Mondor disease - rare
30
What is the cause of Mondor disease?
Acute thrombophlebitis of the superficial veins of the breast or chest wall
31
What 3 veins are most commonly affected by Mondor disease?
1. Lateral thoracic 2. Thoracoepigastric 3. Superior epigastric veins
32
SF of mondor disease?
1. Dilated vein with internal echoes (clotted blood) 2. Cannot fully compress 3. Absent or partial blood flow seen 4. Increased echogenicity and thickness of surrounding tissues
33
Name the 4 trauma related masses.
1. Hematoma 2. Seroma 3. Fat necrosis 4. Post surgical scar
34
Patient symptoms with a hematoma?
1. Skin bruising 2. Palpable 3. Tender 4. Skin thickening
35
Stages of a hematoma?
1. Anechoic 2. Complicated with internal echoes 3. Echogenic clot 4. Liquefaction
36
Common treatment of a hematoma?
Resolves on its own
37
What is a seroma?
Collection of serous fluid after a surgery or biopsy
38
SF of seroma?
1. Anechoic or internal echoes 2. Posterior enhancement 3. No vascularity
39
What is an inflammatory, ischemic process due to breast trauma?
Fat necrosis - uncommon
40
SF of fat necrosis (3 different appearances)?
1. Early - echogenic due to fat 2. Oil cyst fat necrosis - fat-fluid levels/rim calcs 3. Fibrotic fat necrosis - solid, spiculated, hypoechoic
41
What is the proliferation of connective tissue at the site of an injury?
Post surgical scar due to scar tissue development
42
SF of post surgical scar?
1. Hypoechoic with lots of shadowing 2. Skin thickening or retraction 3. Transducer pressure may flatten out the scar and reduce the shadow
43
Benign features of a breast mass (5)
1. Echogenic 2. Wider than tall (parallel) 3. Multi-lobulated (smooth) 4. Thin capsule 5. Oval
44
What is the most common benign solid tumour?
Fibroadenoma - ages 15-35
45
What tumour is estrogen-induced?
Fibroadenoma
46
What is the peak incidence of a fibroadenoma?
15-35 years
47
SF of fibroadenoma
1. Oval 2. Hypoechoic 3. Slight vascularity 4. Wider than tall 5. Homogenous 6. Well-circumscribed
48
What is the difference between an adenoma and secretory adenoma?
Adenoma - glandular tissue Secretory - due to pregnancy or lactation from increasing hormone levels
49
SF of secretory adenoma?
1. Well-circumscribed 2. Parallel orientation 3. Increased vascularity 4. Internal areas of increased echogenicity and fluid filled spaces
50
What pathology usually has a leaf shaped pattern?
Phyllodes/Phylloids tumour
51
SF of Phyllodes tumour?
Similar to fibroadenoma but contains cystic spaces
52
T or F? Calcifications are typical of a phyllodes tumour?
FALSE
53
What pathology has varying amounts of normal or dysplastic fibrous, epithelial, and fatty breast tissues?
Hamartoma
54
What is known as a "benign tumour like malformation"?
Hamartoma
55
What pathology is known as a pseudo-tumour?
Hamartoma
56
Patient symptoms of a hamartoma?
1. Painless, palpable 2. Rubbery and soft
57
What is the common size of a hamartoma?
Larger than 3cm
58
SF of a hamartoma?
1. Oval mass 2. Varied appearance, mixed echogenicities 3. Thin echogenic pseudo-capsule
59
What are lipomas composed of and how large are they?
Adipose tissue Between 2-10cm
60
SF of lipoma?
1. Iso-hyperechoic 2. Thin walls 3. Homogenous 4. Compressible
61
What is the most common benign papillary lesion?
INTRA-ductal papilloma
62
Which papillary lesion is a marker for increase risk of breast cancer?
Juvenile papillomatosis
63
In which duct does an intra-ductal papillary lesion usually present?
Centrally in a larger lactiferous duct rather than a TDLU
64
What is the most common cause of spontaneous bloody nipple discharge from a single breast duct?
Benign papilloma
65
SF of intra-ductal papilloma?
1. Duct dilation 2. Mass within ducts 3. Stalk vascularity
66
What is the cause of an intra-cystic papilloma?
Papilloma inside a duct causes a blockage and a cyst form around the lesion

Pediatric and Superficial Structures (23 decks)

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