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Breast and Scrotal > Breast PowerPoint > Flashcards

Breast PowerPoint Flashcards

1
Q

Indications

A

Palpable breast lumpCorrelation with mammography or MRIFibrocystic changesPregnant or lactating patientsBreast augmentationAxillary lumpPost-surgical or post irradiated breastGuidance for interventional procedures

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2
Q

Main purpose of breast evaluation is the

A

detection and diagnosis of breast cancer in its early and curable stages

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3
Q

Three general categories of breast imaging, two of which involve breast ultrasound

A

Breast cancer screening (does not generally involve ultrasound)Diagnostic (consultive; problem solving; workup) breast imagingDiagnostic and interventional breast procedures

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4
Q

Regular clinical breast exams

A

by a physician every three years until age 40 then yearlyScreening mammography begins at age 40

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5
Q

Ultrasound of the breast is

A

safer and more accurate in young dense breast

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6
Q

Ultrasound can differentiate

A

solid masses from fluid filled cystscan visualize tissue adjacent to implants or other structures that limit mammography

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7
Q

Interventional breast procedures Cyst aspirations can be performed

A

to assess the lesion as a complex cyst or mass

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8
Q

Interventional breast procedures Under sonographic guidance

A

needle guidance in an attempt to aspirate fluid, which would be diagnostic of a complex cystused to guide a fine-needle aspiration cytology (FNAC), abscess or seroma drainage and large-core needle biopsy (for tissue diagnosis)

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9
Q

Interventional breast procedures Needle localization

A

preoperative wire localization and injection of radioactive tracer for sentinel node identification

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10
Q

Interventional breast procedures The key to needle visualization is

A

to keep the needle as to the transducer face as possible

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11
Q

Interventional breast procedures Main hazard is

A

piercing of the chest wall

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12
Q

Pathology -benignCyst

A

clinical signs- discomfort, palpable lump, mobilitysmooth walls, anechoic, posterior enhancement

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13
Q

Pathology -benignComplicated cyst

A

clinical signs- may be related to inflammation or hemorrhage within a cyst

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14
Q

Pathology -benignSonographic findings

A

wall thickening or irregularities, septations, internal echos

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15
Q

Solid mass- benignFibroadenoma

A

Most common breast tumorPrimarily in young womenGrowth stimulated by estrogen

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16
Q

Solid mass- benignFibroadenomaClinical Findings

A

Firm, rubbery, freely mobileSlow growing

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17
Q

Solid mass- benignFibroadenomaSonographic Appearance

A

Smooth, rounded marginsLow-level homogeneous internal echosPossible posterior acoustic enhancementTypically hypoechoic

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18
Q

Lipoma- fatty tumor-benign

A

May grow large before being clinically detectedUsually found in middle-aged/postmenopausal womenLarge, soft, poorly demarcated difficult to delineate from surrounding tissue

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19
Q

Lipoma- fatty tumor-benignSonographic Findings

A

Typically smooth wallsHypoechoic similar to breast fatPosterior acoustic enhancementEasily compressible

20
Q

Fat Necrosis- benign

A

Caused by trauma, surgery, radiation treatment, mastitisSpherical nodule, superficial under layer of calcified necrosis

21
Q

Fat Necrosis- benignSonographic Findings

A

IrregularComplex low-level echosMay mimic malignant massAcoustic shadowing may or may not be present

22
Q

Abscess-benign

A

PainSwellingFebrileEnlarged axillary nodes

23
Q

Abscess-benign

A

ComplexDiffuse increased echogenicity of the breast (if mastitis)Hyperemia with color and or/ power Doppler

24
Q

Papillomas -benign

A

arise from lining of breast ducts, retroareolar area most common Bloody discharge from single duct

25
Q

Papillomas -benignSonographic Findings

A

Tiny papilloma may not be detectedMay cause dilatation of a single duct

26
Q

Papillomas -benignIntracystic papillomas

A

soft tissue mass growing into lumen of cystic lesion

27
Q

Sebaceous cysts-benign

A

obstruction of sebaceous gland or hair follicle within dermal layer of skin

28
Q

Sebaceous cysts-benign Sonographic Findings

A

Rounded, well defined mass with low to medium level echogenicityWall calcification possible

29
Q

Phyllodes- benign/malignant

A

borderline or transitional form between benign and malignant tumorCan grow quite largeDevelop in women between ages 40-60

30
Q

Phyllodes- benign/malignantSonographic Findings

A

Well-defined, lobulated solid mass with possible internal cystic spaces

31
Q

Solid mass - malignant

A

Ductal non-invasive carcinoma in-situ (DCIS)Lobular carcinoma-in situ (LCIS)Invasive ductal carcinoma in-situ (IDC)Invasive lobular carcinoma (ILC)MedullaryColloid /MucinousPapillary

32
Q

Ductal carcinoma in-situ

A

most common non-invasive carcinomaAsymptomatic, palpable mass, nipple discharge

33
Q

Ductal carcinoma in-situMammography findings

A

microcalcifications

34
Q

Ductal carcinoma in-situSonographic findings

A

intraductal massmicrocalcifications irregular ductal dilatationarchitectural distortion

35
Q

Lobular carcinoma in-situ (LCIS)

A

generally affects premenopausal womendistinct tumor not a feature

36
Q

Lobular carcinoma in-situ (LCIS)Sonographic Appearance

A

bilateral, multicentricmimics fibrocystic disease

37
Q

Invasive ductal carcinoma-IDC

A

Most common malignancyHard fixed massSkin dimpling or skin/nipple retraction

38
Q

Invasive ductal carcinoma-IDCMammography findings

A

Asymmetric Radiopaque speculated mass Microcalcifications Thickened and retracted Cooper’s ligament

39
Q

Invasive ductal carcinoma-IDCSonographic findings

A

Solid massHypoechoicHeterogeneousTaller than wide orientationDistal acoustic shadowingPossible- microlobulations, microcalcification, ductal extension branch pattern, fascial plane disruption

40
Q

Invasive lobular carcinoma-(ILC)

A

Mammography can underestimate the extent

41
Q

Invasive lobular carcinoma-(ILC)Sonographic Findings

A

Possible speculated mass mimicking invasive ductal carcinomaArchitectural distortion

42
Q

Medullary

A

Circumscribed, non-tender, often large palpable massMay be mildly compressible and movableOften located in peripheral breastLow incidence of lymph node involvement Prevalence in younger females

43
Q

Medullary Sonographic findings

A

Solid hypoechoic mass; round, oval, or lobulated shapeCircumscribed margins; surface irregularities possibleHomogeneous/mildly heterogeneousAcoustic enhancement Hemorrhage or cystic degeneration may be noted

44
Q

Colloid/MucinousSonographic Findings

A

Well-defined marginsHypoechoic or isoechoic to fatHomogeneousPossible microlobulations

45
Q

Papillary

A

Subareolar palpable massMay protrude and effect skinMay cause skin dimpling and retractionPossible bloody nipple dischargeMimics non-invasive papillary carcinoma or papilloma

46
Q

Breast implants

A

Can be challenging to scan Can be even more challenging to biopsy

Breast and Scrotal (5 decks)

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