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Breast Sonography > Breast Pathology > Flashcards

Breast Pathology Flashcards

1
Q

What typically benign characteristics does a mucinous or colloid carcinoma demonstrate?

A

Posterior acoustic enhancement

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2
Q

“Breast within a breast” is a classic characteristic on mammo for what tumor?

A

Fibroadenolipoma

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3
Q

Normal skin thickness

A

2mm or less

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4
Q

Highly speculative calcifications is a characteristic typical of what?

A

Ductal Carcinoma in Situ (DCIS)

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5
Q

Scaling and redness of the nipple, often confused with eczema is:

A

Paget’s disease if the nipple

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6
Q

May displace the nipple:

A

Juvenile fibroadenoma

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7
Q

Oil cysts may be the result of

A

Fat necrosis

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8
Q

The most common abnormality involving the breast is:

A

Fibrocystic breast changes

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9
Q

Most common metastatic lesion from the breast :

A

Metastatic Breast Cancer from the other breast

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10
Q

Which tumor originates from the lining of the lactiferous duct?

A

Papilloma

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11
Q

Medullary Carcinomas are often confused with:

A

Fibroadenomas

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12
Q

What effect does a benign mass usually have on fibrous planes within the breast?

A

Benign masses have no effect on adjacent tissue planes

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13
Q

What tumor is always considered invasive breast carcinoma?

A

Medullary carcinoma

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14
Q

A BIRADS 5 tumor likely to be a carcinoma is:

A

Highly suggestive of malignancy

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15
Q

Well defined, thick walled lesion with few floating internal echoes and septations may represent:

A

An inflammatory cyst

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16
Q

Most common post surgical breast complication

A

Seroma

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17
Q

Phyllodes tumors have a higher likelihood of being malignant when they are greater than

A

3 cm and exhibit cystic spaces

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18
Q

Which type of breast cancer presents hystologically with its cells infiltrating surrounding tissue in a uniform, linear arrangement

A

Invasive Lobular Carcinoma

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19
Q

How is DCIS typically discovered?

A

Microcalcifications on the mammogram

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20
Q

Benign mass characteristics:

A

Smooth contours and a thin echogenic capsule

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21
Q

Polymastia refers to:

A

The presence of accessory glandular tissue

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22
Q

Approximately what percentage of breast pathology do fibroadenomas have

A

50%

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23
Q

What differentiates malignant phyllodes from the benign version?

A

Patients with Malignant Phyllodes are typically older than patients with benign Phyllodes tumor

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24
Q

Acute infection of the breast occurs most often:

A

During lactation

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25
Q

What does “secondary primaries” mean?

A

Breast cancer recurrence

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26
Q

Characteristics of simple cysts

A

Smooth contour with well defined borders

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27
Q

Cystic lesion less than 2 mm must be watched carefully because:

A

They are too small to demonstrate all the characteristics of a simple cyst

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28
Q

“Swiss cheese” appearance is a description used for what tumor?

A

Juvenile papilloma

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29
Q

Tumor characteristics most consistent with malignancy:

A

Stellar pattern, hypoechogenicity and angular margins

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30
Q

Fat necrosis usually occurs most frequently following breast trauma

A

True

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31
Q

Which group of invasive breast cancers has the worst prognosis?

A

Invasive Ductal Carcinoma (NOS)

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32
Q

Approximately what percentage of vascularity do malignant breast masses usually have?

A

30% (Hypervascular)

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33
Q

LCIS is not considered a true cancer

A

True

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34
Q

Lipomas are more compressible than fibroadenoma

A

True

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35
Q

Patient with h/o Burkett’s, multiple palpable masses in the Rt axilla and hypoechoic mass with irregular boarders in the Rt breast is most likely to have:

A

Breast lymphoma

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36
Q

Which type of breast cancer contains both glandular and non glandular patterns with epithelial or mesenchymal tissue component?

A

Metaplastic Carcinoma

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37
Q

Micro and macrocystic breast disease makes up approximately what percent of all lesions identified clinically and/or on mammogram?

A

25%

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38
Q

Most common benign soft tissue tumor of the breast:

A

Lipoma

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39
Q

Most common type of invasive carcinoma

A

Invasive Ductal Carcinoma

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40
Q

Galactoceles may be simple or complex in appearance

A

True

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41
Q

A patient with a breast that does not include a nipple or areola but does contain glandular tissue is said to have:

A

Athelia

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42
Q

Tubular Adenomas and Fibroadenomas may be differentiated by what ultrasound appearance?

A

Presence of tightly packed, punctuate calcifications

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43
Q

Multicentric breast carcinoma is:

A

All the tumors formed separately in different areas of the breast

44
Q

Fibroadenomas rarely become malignant

A

True

45
Q

Puerperal mastitis is most commonly precipitated by

A

Milk Stasis

46
Q

Highest percentage of malignant breast tumors occur in which breast location

A

Upper Outer Quadrant

47
Q

Hyperechogenicity in a mass is usually a benign characteristic

A

True

48
Q

Malignant tumor vascularity displays:

A

Multiple shunts

49
Q

On mammogram there’s a new, fairly well circumscribed density in the UOQ. This is a BIRADS category:

A

0

50
Q

Most common cause of bloody nipple discharge

A

Papillomas

51
Q

Phyllodes tumor with cystic spaces is suspicious for

A

Malignant solid breast pathology

52
Q

Characteristics of a breast abscess:

A

Fever, a painful, swollen breast. Overlying skin is red and warm to the touch with complex fluid collection seen on ultrasound

53
Q

*Specialized type of invasive Ductal Carcinoma

A

Tubular carcinoma

54
Q

Defined as “Epithelial proliferation that is still confined to the TDLU”

A

Non invasive carcinoma

55
Q

Multifocal breast cancer is defined as

A

Multiple foci of cancer in the same quadrant of the breast

56
Q

Current average of local breast cancer recurrence rate at 5 years following lumpectomy

A

4%

57
Q

Post lumpectomy surgical scars are carefully monitored for tumor recurrence. Recurrence may be suspected if

A

The size of the scar increases after 2 stable examinations

58
Q

In the lactating patient, breast tissue often appears _______ in comparison to the non-lactating patient.

A

More echogenic

59
Q

Which type of calcification is considered most suspicious for malignancy of the breast?

A

Fine Linear pleomorphic calcifications

60
Q

What is the benign lesion that may transform into an oil cyst and will always demonstrate posterior acoustic enhancement?

A

Galactocele

61
Q

An oil cyst may mimic the appearance of:

A

Carcinoma

62
Q

Characterized by thrombophlebitis of the subcutaneous veins of the breast.

A

Mondor’s Disease of the breast

63
Q

Not a true cancer but Considered a marker for increased risk of breast carcinoma

A

LCIS

64
Q

Usually associated with a focus of DCIS that demonstrates as a small spiculated mass and is characterized microscopically by relatively uniform angulated small ducts which invade the mammary stroma

A

Tubular Carcinoma

65
Q

Describe the spread of Mets breast cancer from most common to least common

A

Contralateral breast, bone, lung, liver

66
Q

Approximate percentage of breast cancer located in the retroareolar region

A

17%

67
Q

BIRADS categories

A

1: Negative
2: Benign
3: Probably Benign
4: Suspicious
5: Highly Suggestive of Malignancy
6: Known Biopsy-Proven Malignancy

68
Q

Fibrous Ridge is considered a pseudomass

A

True

69
Q

Malignant lesions tend to have what effect on tissue planes?

A

Cross the plane in an infiltrative fashion. Interrupts the tissue plane or converges towards it

70
Q

Cysts are most common in women aged:

A

35-54

71
Q

Approximately what percentage of Fibroadenomas have a complex appearance?

A

33%

72
Q

Solitary papillomas usually are located:

A

Subareolar

73
Q

Skin thickening can be related to breast trauma

A

True

74
Q

Why do Fibroadenomas often significantly increase in volume during pregnancy and lactation?

A

They are affected by rising estrogen levels

75
Q

Sebaceous cysts are aka

A

Epidermal inclusion cysts

76
Q

BIRADS final assessment of 1 means:

A

The mammo and/or ultrasound does not demonstrate any pathology

77
Q

Breast implant associated anaplastic large cell lymphoma (BIA-ALCL) is associated with which type of breast implants?

A

Textured surface implants

78
Q

What is duct extension?

A

Tumor extends in a single duct toward the nipple

79
Q

Most common form of supernumerary breast tissue is:

A

Polythelia

80
Q

Which characteristic indicates the highest positive predictive value for malignancy?

A

Angular margins

81
Q

Increased breast density increases the patients risk of breast cancer.

A

True

82
Q

What is the oval macrolobulated mass with fibrotic septae that can grow rapidly and will most likely regress when lactation ceases.

A

Lactating adenoma

83
Q

Periductal mastitis can be confused with:

A

Duct ectasia

84
Q

A 28 y/o patient presents to the department with multiple firm to hard palpable lumps that are easily movable. She is type 1 diabetic. She most likely has:

A

Diabetic fibrous mastopathy

85
Q

What percentage of intraductal carcinomas form a stellar configuration?

A

66%

86
Q

Medullary carcinoma may be confused clinically with:

A

Fibroadenoma

87
Q

Most common extramammary Mets to the breast

A

Malignant melanoma

88
Q

Bilateral regional lymph node assessment should be included in the routine US protocol on patients who:

A

Had a h/o Breast cancer who have had a lumpectomy

89
Q

Benign breast lesions are usually parallel to the chest wall

A

True

90
Q

Peau d’Orange is caused by:

A

The blockage of lymph glands due to an underlying cancer. (Usually inflammatory breast carcinoma)

91
Q

The most common location for supernumerary breast tissue is:

A

Abdomen

92
Q

A classic fibroadenoma should be biopseid if greater than:

A

4cm

93
Q

Fat necrosis is most common in_____ with large breasts.

A

Obese women

94
Q

Sonographic appearance of a high grade invasive Ductal carcinoma

A

Hypoechoic, angular margins and posterior acoustic enhancement

95
Q

Most aggressive form of DCIS is:

A

High grade or Comedo

96
Q

Lymphoma found in pregnant and lactating women that has a poor prognosis

A

Burkitt’s Lymphoma

97
Q

Absence of the nipple and areola in the presence of glandular tissue

A

Athelia

98
Q

Clinicians describe malignant masses as “firm, or hard and gritty” due to the:

A

Fibroelastic host response

99
Q

Which invasive breast cancer has an excellent prognosis with lymph node involvement being uncommon

A

Adenoid cystic carcinoma

100
Q

Proliferation of the ductules and lobules:

A

Adenosis

101
Q

Which type of cyst demonstrates a teacup appearance

A

Milk of calcium cyst

102
Q

Solid benign breast mass that displays tightly packed punctuate calcifications scattered through the mass

A

Tubular adenoma

103
Q

Sclerosing Duct Hyperplasia is aka

A

Radial Scar

104
Q

Hamartomas aka

A

Fibroadenolipoma or Adenifibrolipoma

105
Q

Usually benign lesion of the breast, not related to trauma or surgery. If visible on US it appears as an ill-defined subtle area of architectural distortion, or irregular shape hypoechoic mass with or w/o posterior shadowing

A

Radial scar

106
Q

Br Ca recurrence receptors from highest to lowest:

A

Triple-Negative disease (6.9%)
Estrogen receptor-Negative Disease (4.7%)
HER2-Positive disease (4.7%)
Triple-positive disease (3%)

107
Q

The underlying cause of radial scars is:

A

Unknown

Breast Sonography (5 decks)

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