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Pediatric and Superficial Structures > Benign Breast Pathology > Flashcards

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
Q

What is the most common location of an abscess in the breast?

A

Sub-areolar

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26
Q

Patient symptoms of breast abscess?

A
  1. Elevated WBC
  2. Tender/palpable
  3. Inflammation (mastitis)
  4. Pain
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27
Q

SF of a breast abscess?

A
  1. Thickened, edematous walls
  2. Complex fluid collection with internal echoes
  3. Possible air contained within
  4. Vascularity SURROUNDING abscess
28
Q

Common treatment for an abscess?

A

IV antibiotics

29
Q

What benign pathology can occur in both males or females?

A

Mondor disease - rare

30
Q

What is the cause of Mondor disease?

A

Acute thrombophlebitis of the superficial veins of the breast or chest wall

31
Q

What 3 veins are most commonly affected by Mondor disease?

A
  1. Lateral thoracic
  2. Thoracoepigastric
  3. Superior epigastric veins
32
Q

SF of mondor disease?

A
  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
Q

Name the 4 trauma related masses.

A
  1. Hematoma
  2. Seroma
  3. Fat necrosis
  4. Post surgical scar
34
Q

Patient symptoms with a hematoma?

A
  1. Skin bruising
  2. Palpable
  3. Tender
  4. Skin thickening
35
Q

Stages of a hematoma?

A
  1. Anechoic
  2. Complicated with internal echoes
  3. Echogenic clot
  4. Liquefaction
36
Q

Common treatment of a hematoma?

A

Resolves on its own

37
Q

What is a seroma?

A

Collection of serous fluid after a surgery or biopsy

38
Q

SF of seroma?

A
  1. Anechoic or internal echoes
  2. Posterior enhancement
  3. No vascularity
39
Q

What is an inflammatory, ischemic process due to breast trauma?

A

Fat necrosis - uncommon

40
Q

SF of fat necrosis (3 different appearances)?

A
  1. Early - echogenic due to fat
  2. Oil cyst fat necrosis - fat-fluid levels/rim calcs
  3. Fibrotic fat necrosis - solid, spiculated, hypoechoic
41
Q

What is the proliferation of connective tissue at the site of an injury?

A

Post surgical scar due to scar tissue development

42
Q

SF of post surgical scar?

A
  1. Hypoechoic with lots of shadowing
  2. Skin thickening or retraction
  3. Transducer pressure may flatten out the scar and reduce the shadow
43
Q

Benign features of a breast mass (5)

A
  1. Echogenic
  2. Wider than tall (parallel)
  3. Multi-lobulated (smooth)
  4. Thin capsule
  5. Oval
44
Q

What is the most common benign solid tumour?

A

Fibroadenoma - ages 15-35

45
Q

What tumour is estrogen-induced?

A

Fibroadenoma

46
Q

What is the peak incidence of a fibroadenoma?

A

15-35 years

47
Q

SF of fibroadenoma

A
  1. Oval
  2. Hypoechoic
  3. Slight vascularity
  4. Wider than tall
  5. Homogenous
  6. Well-circumscribed
48
Q

What is the difference between an adenoma and secretory adenoma?

A

Adenoma - glandular tissue

Secretory - due to pregnancy or lactation from increasing hormone levels

49
Q

SF of secretory adenoma?

A
  1. Well-circumscribed
  2. Parallel orientation
  3. Increased vascularity
  4. Internal areas of increased echogenicity and fluid filled spaces
50
Q

What pathology usually has a leaf shaped pattern?

A

Phyllodes/Phylloids tumour

51
Q

SF of Phyllodes tumour?

A

Similar to fibroadenoma but contains cystic spaces

52
Q

T or F? Calcifications are typical of a phyllodes tumour?

A

FALSE

53
Q

What pathology has varying amounts of normal or dysplastic fibrous, epithelial, and fatty breast tissues?

A

Hamartoma

54
Q

What is known as a “benign tumour like malformation”?

A

Hamartoma

55
Q

What pathology is known as a pseudo-tumour?

A

Hamartoma

56
Q

Patient symptoms of a hamartoma?

A
  1. Painless, palpable
  2. Rubbery and soft
57
Q

What is the common size of a hamartoma?

A

Larger than 3cm

58
Q

SF of a hamartoma?

A
  1. Oval mass
  2. Varied appearance, mixed echogenicities
  3. Thin echogenic pseudo-capsule
59
Q

What are lipomas composed of and how large are they?

A

Adipose tissue
Between 2-10cm

60
Q

SF of lipoma?

A
  1. Iso-hyperechoic
  2. Thin walls
  3. Homogenous
  4. Compressible
61
Q

What is the most common benign papillary lesion?

A

INTRA-ductal papilloma

62
Q

Which papillary lesion is a marker for increase risk of breast cancer?

A

Juvenile papillomatosis

63
Q

In which duct does an intra-ductal papillary lesion usually present?

A

Centrally in a larger lactiferous duct rather than a TDLU

64
Q

What is the most common cause of spontaneous bloody nipple discharge from a single breast duct?

A

Benign papilloma

65
Q

SF of intra-ductal papilloma?

A
  1. Duct dilation
  2. Mass within ducts
  3. Stalk vascularity
66
Q

What is the cause of an intra-cystic papilloma?

A

Papilloma inside a duct causes a blockage and a cyst form around the lesion

Pediatric and Superficial Structures (23 decks)

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