Breast Review Flashcards
When does female breast tissue begin to develop beyond male breast tissue?
puberty
Which technique uses vocal vibrations to differentiate benign and dense breast tissue?
vocal fremitus
With the ABC and 123 method, explain what the letter and number tell us about a breast mass.
ABC: depth, A closest to nipple, C closest to muscle
123: distance, 1 closest to nipple, 3 furthest from nipple
Name 5 indications for a breast ultrasound.
dense breasts, mammo finding, palpable mass, clinical finding, axillary nodes, pain, follow up
What part of the breast has the most breast tissue?
UOQ
Which germ layer is the nipple formed from?
mesoderm
In breast sonography, why are transverse and sagittal scanning planes not utilized?
To follow the direction of the lobes in the breast
Name 3 parenchymal elements of the breast.
acini, lobules, lobes, ducts
What is it called when there are 2 or more masses less than 5 cm away from each other?
multifocal
What is the smallest functional unit of the breast?
acini
Why does patient positioning vary between individuals and why is it important to position correctly?
dependent on breast size, nipple needs to be centered and breast needs to be flat for consistency in labeling
Contrary to common standards, many malignancies can display which three characteristics?
homogenous, hyperechoic, enhancement
Name 3 short term implant complications.
pain, tenderness, hematoma, abscess, seroma, loss of nipple sensation
What is the most common implant complication and why is it a necessary process?
capsular fibrosis, the body blocks it off as a foreign object which helps with healing and preventing rupture/attacking implant
What kind of artifact will be seen with an extracapsular silicone implant rupture?
snowstorm sign
Which location is an implant located in when it is anterior to the muscle and posterior to the breast tissue?
subglandular
Which two scanning techniques should be practiced to ensure proper evaluation of mass vascularity?
light pressure, power doppler
What are the two types of malignant nipple discharge and what do they each indicate?
blood: invasive cancer cells in ducts
clear: proliferation of ductal epithelial cells
Which sonographic artifact occurs with silicone implants?
propagation speed, sound travels through silicone slower than soft tissue, posterior structures appear deeper than they actually are
Benign masses are allowed to have an echogenic halo as long as the tumor is not taller than wide.
T or F
false
Name two ways in which you can differentiate a radial scar and a scar.
scar will extend through skin/subcutaneous layer, clinical history
Which two benign breast findings should be surgically removed due to their increased likelihood of becoming cancerous?
PASH, radial scar
Name three clinical findings of acute lactational mastitis?
tender, swelling, plugged duct, purulent discharge, skin thickening, erythema, enlarged LNs, leukocytosis, fever
When should benign cysts begin to involute?
menopause
What solid breast mass is an estrogen induced tumor made of epithelial and connective tissues?
fibroadenoma
Why does a hamartoma appear heterogenous on sonography?
mixed components - fibrous, glandular, fatty
What is the most important differentiation between a complicated and complex cyst?
complex: solid component
complicated: debris/other nonsolid material
What is the most common cause of acute mastitis? Name 3 sonographic features you will see with it.
lactation
skin thickening, edema, no focal mass, duct dilatation, parenchymal edema
_____________ originates in the epithelial cells of acini and does not extend past the basement membrane. It is also a marker for an increased risk of future development of IDC.
LCIS
Name 3 CLINICAL findings of inflammatory carcinoma.
peau d’orange, erythema, skin thickening, nipple retraction, swollen, tender, hard breast, enlarged LNs
Name 3 risk factors for breast cancer.
- age
- family history
- benign proliferative disease
- early menarche, late menopause
- late pregnancy
- nulliparity
- radiation exposure
- estrogen use
- post meno obesity
What is the most common type of noninvasive breast cancer?
DCIS
Which type of breast cancer can undergo necrosis and has benign characteristics?
medullary carcinoma
Name the type of breast cancer that will display architectural distortion and will invade the surrounding connective tissue.
invasive ductal carcinoma
Stage ___ is when there is a mass less then 2 cm with NO lymph node involvement.
1
_________ is an uncommon form of DCIS that causes tumor cells to spread along a subareolar duct and it affects the nipple or areola.
Paget’s disease of the nipple
What is the most common hematogenous mets route to a distant site?
bone
Which type of breast cancer is the malignant counterpart of a fibroadenoma?
Phyllode’s tumor
Which type of breast cancer has the worst prognosis and accounts for 80% of all breast malignancies?
IDC
Which type of breast cancer will show a fibrovascular stalk via ultrasound and a cluster of circumscribed masses in one quadrant via mammography.
papillary carcinoma
Stage _____ is when there is a tumor larger than 5 cm with NO axillary lymph node involvement.
2
Name 3 benign masses that can mimic Invasive Ductal Carcinoma.
- fat necrosis
- radial scar
- sclerosing adenosis
- scar
- fibrosclerosis
- fibrous mastopathy
- granular cell tumor
Which type of breast cancer can be pure or mixed and has cells floating in pools of extracellular mucin presenting itself as a mildly compressible palpable mass?
colloid mucinous carcinoma
Why is the MLO projection the most valuable mammographic view?
more breast tissue evaluation
How is tomosynthesis mammography different from 2D mammography?
Tomo takes multiple xrays in a row giving the appearance of 3D by scrolling through the images stacked on one another. More efficient and diagnostic.
Which mammographic diagnostic view uses a smaller paddle to apply more compression to one area of the breast?
spot compression
When reading a mammogram report you see that the Radiologist documented a BI-RAD: Category 4A. What does this mean?
low suspicion for malignancy
Why is the Eklund view important?
Displace implant to evaluate for breast tissue masses
Describe how a spot magnification is performed and why a Radiologist would request it.
Spot paddle is used with a mag platform. Breast is brought closer to Xray machine giving the picture a magnification. Used for calcifications seen on mammo.
