breast Flashcards
breast danger zones
- medial/inferior (medial often seen on CC , not MLO and Infpst often on MLO/not CC)
- retroglandular
- where there is no dense fibroglandular tissue
where does nipple overlie?
4th IC space
retraction vs inversion
- inversion-nipple invaginate into breast
- retraction-nipple pulled back slightly
- both N if chronic
terminal duct lobular unit
-lobules (milk makers) + duct
-
order of lobule and duct system
TDLU (lobule + duct) –> major duct –> lactiferous sinus (dilated portion of major duct) –> nipple
-5-10 ductal openings at nipple
breast blood supply
- internal mammary-60%
- lateral thoracic
- intercostal perforators
lymphatic drainage
- axilla-97%
- internal mammary nodes-3%
axillary node levels
- pec minor=landmark
- 1) lat to pec minor
2) deep to pec minor
3) medal & above pec minor - rotter node: btw pec minor and major. Considered same as level 2
Rotter nodes
-btw pec minor and maj. “level 2 nodes”
mets to int mammary node
- medial cancer
- rare in isolation, ie: already in axilla
sternalis m
UL
CC view
ectopic breast tissue
- axilla-MC
- inframammary fold-2nd MC
milk streak
embryologic loc of normal breast and loc of ectopic breast tissue
estrogen vs progesterone effs on breast tissue during dev
- estrogen: duct elongation, branching
- prog: lobule prol
- don’t bx a breast bud/prepubescent breast
where do most cancers start?
- upper outer
- TLDU
maximum breast tenderness during menstrual cycle
day 27-30
peak time for breast pain/cyst formation: premen, men, perimeno, meno
perimenopause (50s)
when do fibroadenomas degenrate
menopause
when do secretary calcifications development?
10-20 yrs after menopaus
best time for mammogram or MRI?
- follicular phase
- for MR: estrogen cause contrast enh of benign br parenchyma in premenopausal women. greatest in wks 1 and 4. ie: 2nd wk best!
breast change during pregnancy
- tubes and ducts prol
- denser (during 3rd TM)–> hypoechoic
breast change during peri-menopause
shortening follicular phase/(-) estrogen –> (+) prog effs ==>. (+) pain, fibrocystic change, cyst formation
breast change during menopause
- lobules (-)
- ducts stay but ectatic
- FA degen (they like estrogen)
- secr Ca 15-20 yrs after
effects of antipsychotics
increased density