Breast Flashcards
Shape of benign breast mass (# or less gentle lobulations)
Three or less gentle lobulations
Galactocele
Cyst caused by obstruction of lactating duct
Mammary zone vs retromammary
mammary: Breast parenchyma lying within superficial fascia (where lobules are)
Retromammary: posterior margin of mammary and pectoralis major
Posterior acoustic attenuation pattern of benign vs malignant
Malignant lesions posterior SHADOW bc they absorb the sound beam
Benign lesions posterior ENHANCEMENT, edge artifact/shadowing
Terminal ductal lobular unit is formed by (2)
What do TDLU’s form?
A small lobular unit formed by the acini and terminal ducts
Several TDLU’s form breast lobes
What is the origin of nearly all breast pathology
Terminal ductal lobular unit
Most common congenital breast anomaly
Polythelia (accessory nipple)
Most common breast cancer, what does it look like?
Invasive ductal carcinoma
Hypoechoic, spiculated mass with posterior shadowing, thick echogenic rim,
taller than wide, vascular stalk
Breast lesion to be DEFINITELY benign:
- 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
BI-RADS
0-6
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
Benign inflammatory (3)
Mastitis
Mondor cord
Abscess
Benign trauma (4)
Seroma
Hematoma
Fat necrosis
Scar
Benign solid (6)
Fibroadenoma Adenoma Phylloides tumour Hamartoma Lipoma Papilloma
“Basket weave” appearance most likely
Fibrocystic change
Simple vs complicated cyst
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
D/D for a cyst with a MURAL NODULE (4)
Intracystic papilloma
Atypical ductal hyperplasia
Ductal carcinoma in situ
Papillary carcinoma
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
Mondor cord
Benign trauma (4)
Hematoma
Seroma - serum within surgical cavity
Fat necrosis
Occlusion cyst (oil cyst) in a surgical scar
Most common benign solid tumour of female breast -
Age group
Describe
Size
Fibroadenoma
15-35 year
Smooth solid ovoid mass subtle posterior enhancement <3 cm
What is very similar to fibroadenomas in appearance?
How does it differ?
Phyllodes
Differs from fibroadenomas in that it’s bigger (>5 cm), 40 yr plus age group
Benign tumour :
Oval circumscribed solid mass, areas increased echogenicity, prominent vascularity
Adenoma
hamartoma aka
sono appearance
fibroadenolipomas
proliferation of
fibrous, glandular and fatty tissue
pseudo-encapsulation
containing internal fat
looks like a sausage (fatty bits)
Hyperechoic well defined oval mass
Lipoma
Fibrovascular growths in subareolar region that are iso/hypo solid mass
Papilloma
