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HI RES - BOARDS > Breast > Flashcards

Breast Flashcards

1
Q

Shape of benign breast mass (# or less gentle lobulations)

A

Three or less gentle lobulations

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2
Q

Galactocele

A

Cyst caused by obstruction of lactating duct

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3
Q

Mammary zone vs retromammary

A

mammary: Breast parenchyma lying within superficial fascia (where lobules are)

Retromammary: posterior margin of mammary and pectoralis major

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4
Q

Posterior acoustic attenuation pattern of benign vs malignant

A

Malignant lesions posterior SHADOW bc they absorb the sound beam

Benign lesions posterior ENHANCEMENT, edge artifact/shadowing

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5
Q

Terminal ductal lobular unit is formed by (2)

What do TDLU’s form?

A

A small lobular unit formed by the acini and terminal ducts

Several TDLU’s form breast lobes

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6
Q

What is the origin of nearly all breast pathology

A

Terminal ductal lobular unit

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7
Q

Most common congenital breast anomaly

A

Polythelia (accessory nipple)

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8
Q

Most common breast cancer, what does it look like?

A

Invasive ductal carcinoma

Hypoechoic, spiculated mass with posterior shadowing, thick echogenic rim,
taller than wide, vascular stalk

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9
Q

Breast lesion to be DEFINITELY benign:

A
  • Absence of any malignant characteristics (spiculation, angular margins, taller than wide, shadowing, branching pattern, calcifications)
  • hyperechoic
  • thin, echogenic capsule + ellipsoid shape
  • thin, echogenic capsule + 3 or less lobulations
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10
Q

BI-RADS

0-6

A

0-incomplete
1-normal
2-benign
3-probably benign
4-suspicious: biopsy - A: low, B: intermediate, C: moderate
5-highly suspicious >95% chance malignancy
6-biopsy proven malignancy

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11
Q

Benign inflammatory (3)

A

Mastitis
Mondor cord
Abscess

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12
Q

Benign trauma (4)

A

Seroma
Hematoma
Fat necrosis
Scar

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13
Q

Benign solid (6)

A 
Fibroadenoma
Adenoma
Phylloides tumour
Hamartoma
Lipoma
Papilloma
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14
Q

“Basket weave” appearance most likely

A

Fibrocystic change

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15
Q

Simple vs complicated cyst

A

Simple cyst criteria
-anechoic, well circumscribed, through transmission, thin echogenic capsule, thin edge shadows

Complex cyst

  • meets all the above criteria except that it contains low-level internal echoes or debris
  • thick septations (>0.5mm)
  • mural nodules
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16
Q

D/D for a cyst with a MURAL NODULE (4)

A

Intracystic papilloma
Atypical ductal hyperplasia
Ductal carcinoma in situ
Papillary carcinoma

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17
Q

What do you suspect if you see a small cord like structure/vein, beaded appearance, which does not have any vascularity in a patient with a recent breast surgery

A

Mondor cord

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18
Q

Benign trauma (4)

A

Hematoma
Seroma - serum within surgical cavity
Fat necrosis
Occlusion cyst (oil cyst) in a surgical scar

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19
Q

Most common benign solid tumour of female breast -
Age group
Describe
Size

A

Fibroadenoma
15-35 year
Smooth solid ovoid mass subtle posterior enhancement <3 cm

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20
Q

What is very similar to fibroadenomas in appearance?

How does it differ?

A

Phyllodes

Differs from fibroadenomas in that it’s bigger (>5 cm), 40 yr plus age group

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21
Q

Benign tumour :

Oval circumscribed solid mass, areas increased echogenicity, prominent vascularity

A

Adenoma

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22
Q

hamartoma aka

sono appearance

A

fibroadenolipomas
proliferation of
fibrous, glandular and fatty tissue

pseudo-encapsulation
containing internal fat
looks like a sausage (fatty bits)

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23
Q

Hyperechoic well defined oval mass

A

Lipoma

24
Q

Fibrovascular growths in subareolar region that are iso/hypo solid mass

A

Papilloma

25
Q

Swiss cheese appearance in breast of young patients

A

Juvenile papillomatosis

26
Q

Malignant NON invasive (in situ) breast lesions (3)

A

DCIS (ductal carcinoma)
LCIS (lobular carcinoma)
Pagets

27
Q

What is multifocal invasive

A

Presence of additional malignant lesions within a breast quadrant

Indicates spread of cancer via ducts

28
Q

What is multicentric breast lesions

A

Coexistent cancers within different quadrants / separated by more than 5cm within breast

29
Q

What is carcinoma in situ?

A

Cancer is contained entirely within the tissue of origin, not penetrated tissue boundaries (histological diagnosis)

30
Q

LCIS (lobular carcinoma in situ)

Describe type and presentation

A

Multicentric, bilateral

Not a true cancer - marker of significant increased future risk of developing cancner

31
Q

Most common non-invasive cancer

  • age group
  • distinguishing sono feature (1)
A

Ductal carcinoma in situ
“Intraductal”
50 year old
Microcalcs

32
Q

Eczema/rash around nipple/areola and nipple discharge. Itching/tingling or hypersensitivity of the nipple

Thickened areolar complex and microcalcs

What disease

A

Paget’s disease

33
Q

Infiltrating

A

Cancer crossed multiple tissue boundaries, no longer contained in the tissue of origin

34
Q

Most common breast cancer (invasive)

A

Infiltrating ductal carcinoma

35
Q

D/D for

Hypoechoic vascularized lobulated mass carcinoma (3)

A

Infiltrating ductal
Infiltrating lobular
Medullary

36
Q

Small irregular centrally hypoechoic mass with frank spiculation / surrounded by thick echogenic halo

Adjacent coopers ligament thick

What carcinoma

A

Tubular carcinoma

37
Q

Orange peel appearance/ peau d’orange

A

Inflammatory breast cancer

38
Q

Node most at risk for breast cancer

A

Sentinel node

39
Q

What is the most common source of breast mets (2)

A

MOST common is in contralateral breast

Extramammary primary - melanoma

40
Q

Paget’s disease

A

Eczema/rash around nipple/areola and nipple discharge. Itching/tingling or hypersensitivity of the nipple

Thickened areolar complex and microcalcs

41
Q

nippe discharge D/D (3)

A

papilloma - bloody
paget’s disease
mastitis - thick

42
Q

lipoma location

A

subcutaneous fat

43
Q

malignant breast pathology can be asymptomatic

A

true

44
Q

change in breast/nipple contour - what malignancy

A

invasive ductal carcinoma

45
Q

the superficial and deep fascial planes border what

A

mammary zone

46
Q

malignant breast mass that is hyperechoic

A

medullary carcinoma

47
Q

breast mets primary could be (4)

where are they typically located

A

malignant lymphoma
melanoma
lung
ovarian

subcutaneous tissue

48
Q

what is found in the subcutaneous tissue (3)

A

coopers ligament
breast mets
lipoma

49
Q

*smallest functional unit of breast parenchyma

A

acini

50
Q

*hamartoma is caused by

A

the proliferation of normal breast tissue

51
Q

*what is influenced by estrogen levels

A

fibroadenoma

52
Q

*breast neoplasm that may undergo malignant transformation

A

cystosarcoma phyllodes

53
Q

*echogenicity of a fatty breast lobule is most commonly described as

A

smooth, moderately hypoechoic mass (medium gray echo pattern)

54
Q

*echogenicity of glandular breast tissue when compared to a fatty breast lobule is

A

moderately hyperechoic

55
Q

*most common benign breast lesion in women between ages 35-50 is a

A

simple cyst

56
Q

*well defined malignancies are demonstrated in (3)

vs ill defined

A

well defined:
papillary carcinoma
metastatic breast disease
cytosarcoma phylloides

ill defined: IDC

HI RES - BOARDS (3 decks)

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