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CORE: Mammo > Breast Masses > Flashcards

Breast Masses Flashcards

1
Q

fatty masses and fat containing masses

A

BIRADS 2
fatty masses: lipoma, oil cyst/fat necrosis
fat containing masses: hamartoma, galactocele, intramammary lymph node

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2
Q

lipoma

A

made of mature adiopocytes; palpable mass

capsule required for diagnosis (thin discrete rim); no peripheral calcifications

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3
Q

oil cyst/fat necrosis

A

post trauma/surgery; commonly has dystrophic calcification

fat sponification –> circumscribed lucen lesion that can peripheraly calcify

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4
Q

hamartoma/fibroadenolipoma

A

benign mass containing fat/glandular tissue

breast within a breast; pseudocapsule

any suspicious calcs within should be worked up

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5
Q

galactocele

A

cystic collection of milk that can present as a palpable mass in a lactating woman; fat fluid level

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6
Q

intramammary lymph node

A

typically upper outer quadrant and adjacent to a vessel

normal findings: characteristic reniform shape with fatty hilum

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7
Q

ddx for bilatera enlared lymph nodes

A

systemic inflammatory conditions/neoplastic disease like CLL or lymphoma

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8
Q

solid masses in the breast

A

fibroadenoma, intraductal papilloma/papillary carcinoma, PASH, breast cancer, giant fibroadenoma, phyllodes, lactational adenoma, multiple intraductal papillomas

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9
Q

fibroadenoma

A

young women, palpable mass

firm, mobile mass with oval/lobular equal density circumscribed mass&raquo_space; coarse popcorn calcifications in older women

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10
Q

fibroadenoma BIRADS

A

BIRADS 2

BIRADS 3/4 depending on imaging characteristics

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11
Q

fibroadenoma variants

A

complex fibroadenoma (proliferative elements and internal cysts >3mm), juvenile fibroadenoma (adolescents, rapid growth), giant fibroadenoma (> 8 cm)

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12
Q

phyllodes tumor

A

rapidly growing tumor seen in older women 40-50yo

large, oval, lobular, circumscribed mass

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13
Q

treatment for phyllodes

A

wide resection given risk of malignancy

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14
Q

lactational adenoma

A

2nd/3rd trimester of pregnancy/postpartum period

freely mobile mass which may be tender if it enlarges rapidly

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15
Q

lactational adenoma treatment

A

regresses after lactation ends; no need for excision/biopsy

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16
Q

intraductal papilloma

A

benign tumor of lactiferous ducts; women 30-50yo

fibrovascular stalk/frond like which torsion will cause pain/bleeding

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17
Q

most common cause of pathologic nipple discharge

A

papilloma; DCIS can also present with bloody nipple discharge

18
Q

intraductal papilloma imaging findings

mammo, galactography, US

A

mammo: round/oval circumscribed/irregular mass in the subareolar region
galactography: intraductal filling defect

US: solid round/oval mass; fluid filled duct

19
Q

treatment for intraductal papilloma

A

surgical excision

20
Q

pseudoangiomatous stromal hyperplasia (PASH)

A

benign stromal/epithelial proliferation thought to be under hormonal control

21
Q

imaging findings of PASH

A

mammo: large ill-defined round or oval mass

US: hypoechoic/mixed echogenicity oval or irregular mass

22
Q

breast cancer

A

medullary and mucinous carcinoma may appear as circumscribed round masses or hypoechoic mass on US

internal vascularity

23
Q

giant fibroadenoma size

A

> 8cm

24
Q

multiple solid masses , pathology?

A

multiple intraductal papillomas occur in younger patients, usually peripheral and bilateral

less likely to have nipple discharge if solitary, but more likely to cause breast cancer

multiple well circumscribed masses

25
Q

papillomatosis vs juvenile papillomatosis

A

papillomatosis: microscopic foci of intraductal hyperplasia

juvenile papillomatosis: rare cause of mass that resembles a fibroadenoma in adolescents, women <40

26
Q

common skin masses

A

NF1, steatocystoma multiplex (multiple intradermal oil cysts)

27
Q

NF1 manifestations

A

AD with pigmentary changes (cafe au lait, lisch nodules), neurofibromas

cutaneous neurofibromas are from small nerve tributaries of skin

28
Q

steatocystoma multiplex

A

rare AD; innumeral fat density masses on the skin

29
Q

simple, complicated, complex cysts

A

simple: benign, BIRADS 2; round/oval/gently lobulated with circumscribed marchins/anechoic; posterior enhancement; may be aspirated if causing pain/discomfort
complicated: BIRADS 3 or aspirated (only BLOODY fluid is sent for cytology); low level internal echoes/layering debris
complex: BIRADS 4; cyst with complex features and should be biopsied with core needle and post-biopsy tissue marker

30
Q

masses that appear complex

A

intracystic carcinoma, intracystic papilloma, cystic phyllodes tumor, solid cancer with central necrosis

31
Q

clustered microcyst

A

BIRADS 2 if clearly seen/nonpalpable
apocrine metaplasia/fibrocystic changes; clustered microcysts 2-5mm separated by thin septae; may evolve into a benign cyst

32
Q

spiculated masses

A

IDC, invasive lobular carcinoma, tubular carcinoma, radial scar, post lumpectomy changes, abscess, benign breast fibrosis

33
Q

invasive ductal carcinoma

A

high density spiculated mass; pleomorphic/fine linear branching calcifications present

34
Q

invasive lobular carcinoma

A

10% of all breast cancers
spread via infiltrating pattern surrounding glandular tissue
ma present as a mass or subtle architectural distortion; rarely microcalcifications

often multifocal or bilateral

35
Q

tubular carcinoma

A

small spiculated mass; stable over several priors and slow growing
radial scar > tubular carcinoma?

36
Q

radial scar

A

aka complex sclerosing lesion; benign lesion

adenosis, hyperplasia, central atrophy resulting in architectural distortion

37
Q

postsurgical scar

A

postlumpectomy or exchisional biopsy; may cause volume loss or skin retraction

38
Q

abscess

A

can look like an irregular or spiculated mass

39
Q

benign breast fibrosis/scerosing adnosis/fibrous mastopathy

A

sclerosing adenosis: lobular hyperplasia; microcalcifications may be present

diabetic mastopathy: IDDM with large painless firm breast mass from inflammatory lymphocytes/fibrosis

40
Q

axillary masses

A

breast cancer nodal mets

41
Q

suspicious features of lymph node mets

A

round shape, thickened cortex >3mm, eccentrically thickened cortex, focal outwards cortical bulge, hilar indentation or obliteration of hilum

CORE: Mammo (10 decks)

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