1. simple 2. complex 3. duct ectasia (enlarged) 4. abscess 5. solid benign lesion

breast lesions Flashcards by Sar D

types of cysts

simple
complex
duct ectasia (enlarged)
abscess
solid benign lesion

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most common solid benign lesion

fibroadenoma

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usually in premenopausal state due to estrogen level fluctuation

simple cyst

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• Smooth walls
• Anechoic
• Posterior enhancement
- often compressible

simple cyst

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Wall thickening or irregularities
Septations
Internal echoes

complicated cyst

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characteristics of benign solid lesions of breast

smooth margin
round or oval
wider than tall**
mobile
compressible
avascular
less than 3 gentle lobulations

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age for peak incidence of Fibroadenoma

25-40 yes

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cause of fibroademona

increased estrogen

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common location of fibroadenoma

UOQ

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round/ oval, thin echogenic capsule

characteristics of fibroademona

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age for peak incidence of hamartoma

> 35

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cause of hamartoma

proliferation of fibrous, glandular and fatty tissue

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treatment of fibroademona

minimal / no malignancy potential

-biopsy

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soft and compressible, hyper or hypoechoic

characteristic of hamartoma

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age for peak incidence of fat necrosis

older women bc fat replaces gladular tissue with age

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cause of fat necrosis

trauma, surgery, radiation or cancer of breast

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irregular complex mass with low echos (oil cyst)

characteristic of fat necrosis

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age for peak incidence of cytosarcoma phyllodes

> 45 before menopause

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cause of cystosarcoma phyllodes

fibroadenoma but fast growing (change in estrogen levels)

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solid with multiple cystic spaces and heterogeneous texture

characteristic of cytosarcoma phyllodes

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T/F: phyllodes tumor may undergo malignant transformation

TRUE

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age for peak incidence of mastitis

lactating women

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cause of mastitis

trauma, obstructed ducts, infection

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dilated ducts, hyper vascular glandular parenchyma, inflammed echogenic fat

characteristic of mastitis

treatment option for mastitis

antibiotics

presents with swelling, pain, and redness of skin overlaying breast tissue

abscess

5-10% of what benign breast lesion can develop abscess

mastitis

single or multiloculated hypoechoic area with posterior enhancement, no internal vascularity

abscess

treatment for abscess

incision/ drainage & antibiotics

characteristic of malignant lesion

- hypoechoic - irregular margin - taller than wide** - >3 lobulations - shadowing - hypervascularity - pull on cooper's lig - duct extension or branching

malignant breast lesion with epithelium origin

carcinoma

malignant breast lesion with CT origin

sarcoma

what origin lesion grows faster

sarcoma

modes of spread in breast cancer

1. local invasion via LYMPHATICS to ipsilateral or contalateral lymph nodes 2. distal invasion via blood to different organs (bones, lungs, liver/ brain)

genetic factors that increase risk of BC

BRCA1 and BRCA2 mutation

what type of carcinoma has a higher risk of being invasive (name & %)

ductal (75-80%)

cause of invasive ductal BC

-more fibrous tissue

characteristics of invasive ductal BC

- skin dimpling | - nipple retraction

2nd most common BC (name & %)

invasive lobular 10-15%

T/F invasive lobar BC is commonly found in older women

TRUE

type of BC difficult to detect on imaging

Invasive lobular

rare type of BC (name & %)

medullary carcinoma <5%

characteristic of invasive lobular BC

remain localized longer, bilateral, begin in lobule extend to fatty tissue

round/oval with lobulations, dense cellular with central necrosis, grow fast and spread by lymphatics

characteristic of medullary carcinoma

relatively rare BC (name & %)

colloid or mucinous or gelatinous BC | -3%

slow growing, in older women, resemble fibroademona (smooth, posterior enhancement) with vascularity

colloid or mucinous or gelatinous

BC with low rate of recurrence, slow growth, small (<1cm) in women 40-50yrs, arise from TDLU

tubular

rare 1.5-2.5% BC arise from ducts and spread to epidermal region of nipple

paget's disease (in 6th decade)

sonographically heterogeneous sub areolar mass with irregular margin,

paget's disease

BC gives "orange peel" appearance

inflammatory carcinoma

1-4% in 4th-5th decade. mimmics mastitis

inflammatory carcinoma

treatment for inflammatory carcinoma starts with ___

chemo / radiation

invasive ductal carcinoma - tumors found dilated in lymphatic channels

inflammatory carcinoma

therapeutic aspiration of __, ___, or ___ guided by ultrasound

1. cyst 2. hematoma 2. abscess

extra capsular rupture of implant gives ___ appearance

snow storm

intra capsular rupture of implant gives ___ appearance

stair-case / ladder

standardized way to report risk of breast cancer, numerical score 0-6

BI-RADS (breast imaging reporting and data system)

BI-RADS score of 0

negative - nothing found

BI-RADS score of 6

known biopsy proven malignancy