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Applied Radiographic Pathology 2 > Breast Pathologies > Flashcards

Breast Pathologies Flashcards

1
Q

What influences how Pathologies can be detected In the breast?

A

The density of breast tissue

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2
Q

Where are there more opportunities for superimposition?

A

The more dense the glandular tissue the more opportunities for superimposition of the breast tissue and lesson

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3
Q

What can be difficult to identify/sample/assess?

A

Small lesions, architectural distortion & calcifications

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4
Q

What can mask malignancy?

A

Benign hormonal changes postpartum
Whilst breastfeeding
During menstruation
During HRT (hormone replacement theraphy) or gender reassignment treatment

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5
Q

What are the common causes of increased glandular density?

A

Menstruation
Lactation
HRT
Poor technique
Post surgical scar tissue

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6
Q

How can malignant tumours be categorised?

A

Hormone receptor status

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7
Q

What is the Prevalence of breast cancer?

A

1% of all breast cancer occur In men

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8
Q

What are the risk factors of breast cancer?

A

Gender
Age 35 -70
Family history
HRT (hormone replacement therapy) - current/previous history
Not breast feeding
High oestrogen levels - early menarche, late menopause and no pregnancies
Lifestyle - fat in diet, BMI, alcohol
BRAC1 and BRAC2 gene mutation

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9
Q

What are the signs and symptoms of breast cancer?

A

A lump or thickening in an area of the breast
A change in the size or shape of the breast
Dimpling of the skin
A change in the shape of your nipple particularly if it turns in, sinks into the breast, or has an regular shape
A blood stained discharge from the nipple
A rash on a nipple or surrounding area
A swelling or lump in your armpit

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10
Q

What are the different types of nipple changes?

A

Nipple cleft which is benign, redness, Paget’s disease of the breast, peau d’orange, inversion, tethering, discharge, and thickening

Enlargement and asymmetry, circumferential retraction, paget disease (eczema like condition), dimpling, nodule, ulceration, and peau d’orange

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11
Q

What plane and axis does the breast gets image at?

A

Mediolateral oblique and craniocaudal

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12
Q

What are the radiographic Appearances of breast cancer?

A

Microcalcification
Dense
Margins: irregular or spiculated
Border: blurred, ill-defined or irregular
Size: smaller than palpable mass
Surrounding tissue: infiltrated
Calcification: few, isolated, uncountable, clustered or confined to the area of the lesion

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13
Q

What are the two different microcalcification?

A

Lobular calcification and intraductal calcification

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14
Q

What are lobular and intraductal calcification?

A

Lobular: are almost always benign round, punctate or sharply outlined
Intraductal: irregular, different sizes, linear and are suspicious of malignancy

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15
Q

What are the different staging of the tumour the nodule and metastasis abbreviation and meaning?

A

TX: the tumour cannot be assessed
T0: no evidence of a tumour is present
Tis: the Cancer maybe lcis dcis or target disease
T1: the tumour is 2 cm or smaller in diameter
T2: the tumour is 2-5 cm in diameter
T3: the tumour is more than 5 cm in diameter
T4: the tumour is any size, and it has attached itself to the chest wall and spread to the pectoral (chest) lymph nodes

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16
Q

In TNM what does the M numbers mean when referring to tumour types?

A

M1: normal
M2: probably benign
M3: indeterminate
M4: probably malignant
M5: malignant -definite

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17
Q

What are the different tumour classification staging?

A

Stage 1 cancer a very small tumour no spread
Stage 2 refers to a cancer that has grown but hasn’t spread
Stage 3 refers to a larger cancer which may have spread to the surrounding tissues and/or the lymph nodes and
Stage 4 refers to cancer which has spread from where it originally started to at least one other body organ; also known as “secondary” or “metastatic” cancer, e.g. bone

18
Q

What are the treatment options of breast cancer?

A

It depends on the patients the tumour types/ location
Stage / progression
Hormone receptor status
Genetic predisposition

Surgery - localised tumour
Radiotherapy - localised surrounding tissue
Chemotherapy - systemic
Hormone - systemic (depends on receptor status)
Gene therapy - systemic (depends on genetic status)

19
Q

What is a benign fibroadenoma?

A

Arise from terminal duct lobular unit it is lumps composed of fibrous and glandular tissue which are easy to remove as they have clearly defined edges and are highly mobile lump - breasts mice /mouse appearance

20
Q

Signs and symptoms of benign fibroadenomas?

A

Mobile lump
Lump slowly growing
Painless
Solitary and firm

21
Q

What are the radiographic Appearances of a benign tumour?

A

Smooth dense/ lucent clear defined edges

22
Q

What are the radiographic Appearances of a malignant tumor?

A

Dense
Irregular
Spiculated

23
Q

What are benign cysts?

A

Fluid-filled sac within the breast tissue, round or oval lump with defined edges can be painful

24
Q

What is the prevalence of a benign cyst?

A

Most common in women 30 to 40 years of age

25
Q

How can a cyst be identified?

A

It can be confirmed with the use of ultrasound. Ultrasound can look for nodules, a sign it may be precancerous

26
Q

What is the prevalence of a fibroadenomas?

A

Most common tumour amongst adolescence under 30 years incidence declines with age

27
Q

What is a lipoma?

A

It is a benign lesion usually asymptomatic it can be an incidental finding. Lump.is mobile. Easier to detect in dense breast tissue using mammography. It is also found in males too

28
Q

What is the image orientation in MRI for breast?

A

The person lies prone within a breast coil

29
Q

What is ductal carcinoma in situ - DCIS?

A

Ductal carcinoma in situ is the most common type of non-invasive breast cancer

30
Q

Where does the ductal carcinoma in situ begin?

A

It starts in the milk ducts of the breasts. It is referred to as a non-invasive cancer because it lacks the ability to spread beyond the milk ducts.

31
Q

What is gynecomastia?

A

Gynecomastia is the most common abnormality in the male breast. Significant if new or symptomatic.

32
Q

What is the clinical presentation of gynecomastia?

A

It presents as a soft mobile tender subareolar mass. It has indistinct borders which are a sign of gynecomastia.

33
Q

What is the prevalence of gynecomastia?

A

It’s more presents in 60 to 69 years of age

34
Q

What are the risk factors of gynecomastia?

A

Age
Malnutrition
Cirrhosis of the liver
Chronic kidney failure
Disorders of the testes (male sex organ) including infection trauma, or inborn disorders
Testicular cancer
Anti-androgen treatments for prostate cancer
Hyperthyroidism
Changes in hormone levels/ balance of testosterone/ oestrogen

35
Q

What are some reasons of breast augmentation/ implants?

A

Cosmetic reasons
Preference
As part of reconstructive breast surgery
Implants maybe saline or silicone filled
Their placement may be retro-glandular or retro-muscular
Has a potential to challenge image viewing

36
Q

What is the difference between sub-glandular (retro-glandular) and sub-muscular (retro-muscular) implant placement?

A

Sub-muscular placement is when the pectoral muscles are stretched and extended forward over the ‘saline’ implants.
Sub-glandular placement can be seen when the glandular tissue is displaced and seen as denser and more radiopaque Crescent shaped around the silicone implants

37
Q

What is the purpose of subcutaneous injection of silicone or hyaluronic acid fillers?

A

They add fullness and lift to the breasts.

38
Q

What are some risk factors to injection of silicone or hyaluronic acid fillers?

A

Most of the fillers have been found to be potentially toxic to the breast tissue and can cause significant distortion and superimposition of the surrounding breast tissue.
They are also impossible to see or adequately assess the breast tissue as there is widespread distortion and superposition caused by the silicone and hyaluronic acid deposits.

39
Q

What is the risk of hyaluronic acid?

A

Cytotoxicity pose a significant risk to cellular health due to the potential cytotoxicity of a substance and the potential for tissue contracture (or the displacement of fibrosis of normal breast tissue due to presence of an unrecognised foreign body), causing an immune reaction.

40
Q

What are radiological appearance of benign fibroadenomas?

A

Margins: round, oval, or lobulated
Borders: smooth, regular, well-defined
Size: same as palpable mass
Surrounding tissue: is displaced not infiltrated
Calcification: bilateral, numerous, widely scattered

Applied Radiographic Pathology 2 (7 decks)

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