Breast/prostate

Question 1

Normal size of prostate?

Answer 1

2 x 4 x 3

Question 2

Common abnormality that occurs in regards to prostate

Answer 2

BPH

Question 3

What is the lab value that indicates a malignant process

Answer 3

PSA

Question 4

When a prostate biopsy is done what area might a malignancy occur in?

Answer 4

Peripheral zone

Question 5

What might we see in the superficial areas of the breast (peripheral area)?

Answer 5

Sebaceous or epidermal cyst

Question 6

In what area of the breast do we see lumpy,bumpy tissue?

Answer 6

Subcutaneous

Question 7

What is the functional portion of the breast and how many lobes are located in that area?

Answer 7

Mammary/glandular layer includes the functional portion of the breast and surrounding supportive tissue. Made of 15 to 20 lobes containing milk producing glands and ductal system

Question 8

Cooper’s ligament is the skeletal structure…

Answer 8

Responsible for maintaining the shape and structure of the breast. Connective tissue septa within the breasts form this fibrous skeleton. Sonographic characteristics: echogenic and disbursed in a linear pattern. Best identified when the beam strikes the ligaments at a perpendicular angle

Question 9

As a woman ages glandular breast tissue is replaced by what kind of tissue

Answer 9

Fatty tissue

Question 10

Define Cooper’s ligament

Answer 10

Connective tissue septa that connect perpendicular to the breast lobules and extend out to the skin. Considered the fibrous skeleton supporting the breast glandular tissue

Question 11

What is the echogenicity of the retromammary layer?

Answer 11

Similar in echogenicity and echotexture to the subcutaneous layer although the boundary echoes resemble skin reflections

hypoechoic

Question 12

Sonographic artifacts that help us determine cystic or solid:

Answer 12

Cysts: anechoic, smooth margins, capsule, posterior enhancement, rounded or oval, mobile and compressible, can be multilocular within septations if it’s a complex cyst

Solid: Wall irregularity, nodularity or septations, shadowing, nonuniform internal echoes, thick proteinaceous fluid, non-mobile, non-compressible

Question 13

Lumpy bumpy painful tender breasts that are cyclic and make it hard to identify structures in mammography is termed?

Answer 13

Fibrocystic condition

Question 14

Most common benign breast tumor?

Answer 14

Fibroadenoma

Question 15

Characteristics of papilloma of the breast:

Answer 15

Arise from lining of breast ducts, most common in the Retroareolar area.

Bloody discharge from single duct is common.

Sonographic findings: tiny papilloma may not be detected, may cause dilation of a single duct, small multiple linear and multicentric, intracystic papillomas are soft tissue mass growing into lumen of cystic lesion.

Intracystic lesion growing with fibrovascular stalk.

Occurs most frequently and women 35 to 55.

Raspberry like configuration on mammography.

Question 16

Lymph nodes in the breast region are called?

Answer 16

Axillary or internal mammary nodes

Question 17

Characteristics of breast carcinoma:

Answer 17

Fingerlike projections called spiculations
Sharp, angular borders
Cause skin dimpling or nipple retraction
Taller than wide
Hypoechoic
Posterior shadowing behind
Rigid and noncompressible
Increased vascularity with feeder vessel

Question 18

Skin dimpling may be caused from what

Answer 18

Malignancy

Question 19

Most common reason for scanning a breast with ultrasound?

Answer 19

Palpable mass

Question 20

Primary purpose of breast screening examination?

Answer 20

Detection and diagnosis of breast cancer and it’s early and curable stages

Question 21

Most common protocol we follow for breast screening?

Answer 21

Clock face screening and use of radial and anti-radial. Scanning only the area of interest.

Question 22

Finding of normal breast tissue entering the axillary region is called?

Answer 22

Tail of Spence

Question 23

American Cancer Society recommends everyone and have a mammogram after what age?

Answer 23

40

Question 24

Arterial supply to the breast?

Answer 24

Internal mammary and lateral thoracic arteries

Question 25

Hypertrophy of the dutal elements in a male

Answer 25

Gynecomastia

Question 26

Parameters when it comes to a breast mass, know tools and how to distinguish between benign and malignant:

Answer 26

Benign: smooth, rounded margins; grow horizontally in tissue planes; parallel to chest wall; round or oval shape; wider than tall; isoechoic with breast tissue; exhibit posterior enhancement; mobile and compressible; do not have blood flow

Malignant: fingerlike projections called spiculations; Sharp, angular borders; cause skin dimpling or nipple retraction; taller than wide; hypoechoic; posterior shadowing behind lesion; rigid and non-compressible; stiff and dense; increased vascularity with feeder vessel

Question 27

Ultrasound may not be useful during a biopsy in what instances or situations?

Answer 27

Evaluation of clustered microcalcifications because they are difficult to see by ultrasound,so stereotactic guidance is preferred.

Question 28

Know the protocol for younger women versus older women and the advantages of breast ultrasound over mammography.

Answer 28

Ultrasound of the breast is safer and more accurate in young dense breasts- tissues are not easily visible with mammography. If woman is still in fertile age (before 40) u/s will be used first because we don’t like to radiate young women. U/s can’t differentiate solid masses from fluid filled cyst. Can visualize tissue adjacent to implants or other structures that limit mammography. Used first in pregnant or lactating women and in women with breast augmentation.

Mammography is used for breast calcifications. Hard to differentiate fibrocystic changes or dense tissue on mammography. Difficult to image with implants.