Ch 21 Breast- Fill in the Blank

Question 1

The breast is a modified ________ gland located in the superfical fascia of the anterior chest wall.

Answer 1

sweat

Question 2

sonographically the breast is divided into three layers located between the skin and the pectoralis major muscle on the anterior chest wall. These layers are the ________ layer, the _________ layer, and the _________ layer.

Answer 2

subcutaneous, mammary, retromammary

Question 3

Fat is the least ________ tissue within the breast.

Answer 3

echogenic

Question 4

The fatty tissue appears _______, whereas the ducts, glands, and supporting ligaments appear echogenic.

Answer 4

hypoechoic

Question 5

The ________ quadrant of the breast contains the highest concentration of lobes.

Answer 5

upper outer

Question 6

Each lobe contains _______ (milk-producing glands) that are clustered on the terminal ends of the ducts like grapes on a vine.

Answer 6

acini

Question 7

The ________ muscle lies posterior to the retromammary layer.

Answer 7

pectoralis major

Question 8

The _________ tissue can situate itself in and among the areas of glandular tissue, and in some scanning planes it can mimic isoechoic or hypoechoic masses.

Answer 8

adipose or fatty

Question 9

Sonographically, cancers can be difficult to differentiate in the fatty breast because most cancers appear _______ and can be difficult to differentiate from the normal breast tissue.

Answer 9

hyopechoic

Question 10

The main arterial supply to the breast comes from the internal ________ and the lateral ________ artery.

Answer 10

mammary, thoracic

Question 11

Lymphatic drainage from all parts of the breast generally flows to the _______ lymph nodes.

Answer 11

axillary

Question 12

The primary function of the breast is _______ transport .

Answer 12

fluid

Question 13

The _______ system is critical in the transport of fluids within the breast.

Answer 13

ductal

Question 14

An important function during the reproductive years is for the breast to make ______ from nutrients and water taken from the bloodstream.

Answer 14

milk

Question 15

Milk is produced within the ________ and carried to the nipple by the ducts.

Answer 15

acini

Question 16

Breast development begins before _________ and continues until the patient is approximately 16 years old.

Answer 16

menarche

Question 17

During pregnancy, acinar development is accelerated to enable milk production by estrogen, _________, and prolactin.

Answer 17

progesterone

Question 18

During this time of development, the ductal system proliferates under the influence of ________.

Answer 18

estrogen

Question 19

The hormone produced by the pituitary gland that stimulates the acini to produce and excrete milk is called _______.

Answer 19

prolactin

Question 20

The expulsion of the placenta after birth of a baby causes a drop in circulating progesterone, initiating ______ production within the breasts.

Answer 20

milk

Question 21

The physical stimulation of suckling by the baby initiates the release of ________ (produced by the hypothalamus and released by the pituitary gland), which further incites prolactin secretion, stimulating additional milk production.

Answer 21

oxytocin

Question 22

Full maturation of the acini occurs during lactation and is thought to be mildly protective against the development of breast _______.

Answer 22

cancer

Question 23

Ultrasound may be used for screening purposes in ______ breasts that are _______ and difficult to penetrate by mammography, to evaluate palpable masses that are not visible by mammogram, and to image the deep juxtathoracic tissues not normally visible by mammography.

Answer 23

young, dense

Question 24

Ultrasound is also useful in __________ structures within uniformly dense breast tissue where mammography is limited (e.g., in differentiating solid, round masses from fluid-filled cysts and visualizing tissue adjacent to implants or other structures that limit visualization by mammography).

Answer 24

differentiating

Question 25

A(n) ) _______ aspiration can be performed to determine whether a lesion is a complex cyst or truly a solid mass.

Answer 25

cyst

Question 26

Pertinent clinical information that should be provided by the referring physician includes size and location of the lump, when it was noticed, and its relation to the _______.

Answer 26

menstrual cycle

Question 27

A dominant cyst is frequently ________ or ______ (long axis toward nipple), smooth, soft (some cysts under tension cab be firm and usually very tender), and easily movable.

Answer 27

round, oval

Question 28

Fibroadenomas are usually similar in shape, but they are often quite firm and rubbery in consistency and _________ on ultrasound.

Answer 28

homogeneously solid

Question 29

Breast cancer is usually lobular or _________ in shape, uneven in surface contour (sometimes gritty in texture), and fixed or poorly movable.

Answer 29

irregular

Question 30

Most breast masses that arise during the adolescent years are ________.

Answer 30

fibroadenomas

Question 31

A(n) __________ implant rupture occurs when there is a breach of the membrane surrounding an implant, but the silicone that leaks out is still confined within the fibrous scar tissue that forms a “capsule” around the implant.

Answer 31

intracapsular

Question 32

As the implant collapses and the membrane folds inward, a series of discontinuous echogenic lines parallel to the face of the transducer may be seen and are referred to as the “stepladder sign” or “_________ sign.”

Answer 32

linguine

Question 33

The use of _________ positions is unique to the breast and can often pick up subtle abnormalities extending toward the nipple along the ductal system from the mass.

Answer 33

radial/antiradial

Question 34

________ tend to grow within the ducts and will often follow the ductal system in a radial plane, toward the convergence at the nipple.

Answer 34

malignances

Question 35

A rounded or oval shape is usually associated with ______ lesions, whereas sharp, angular margins are associated with ________ lesions.

Answer 35

benign, malignant

Question 36

The normal tissue planes of the breast are __________ oriented.

Answer 36

horizontally

Question 37

Benign lesions tend to grow within the normal tissue planes, and their long axis lies ________ to the chest wall.

Answer 37

parallel

Question 38

Malignant lesions are able to grow through the connective tissue and may have a(n) ________ orientation when imaging the breast from anterior to posterior.

Answer 38

vertical

Question 39

If a mass measures longer in the anteroposterior dimension (________), than in either transverse or sagittal planes ( ______), the mass has a vertical orientation that is usually described as being “taller than wide” and is suspicious for malignancy.

Answer 39

height, width

Question 40

Malignant masses will often demonstrate increased _________ within the lesion and often have a feeder vessel, which can be identified with careful evaluation.

Answer 40

vascularity

Question 41

Lesions more common to younger women are _______ disease and fibroadenomas.

Answer 41

fibrocystic

Question 42

Older or postmenopausal women are more likely to have _________ papillomas, duct ectasia, and cancer.

Answer 42

intraductal

Question 43

Skin dimpling or ulceration and nipple retraction nearly always result from _______.

Answer 43

cancer

Question 44

Benign tumors are rubbery, ________, and well defineated (as seen in a fibroadenoma), whereas malignant tumors are often stone hard and irregular with a gritty feel.

Answer 44

mobile

Question 45

Clinical signs and symptoms of __________ include the lumps and pain that the patient feels that fluctuate with every monthly cycle. In most cases both breasts are equally involved.

Answer 45

fibrocystic condition

Question 46

The growth of a fibroadenoma is stimulated ________.

Answer 46

estrogen

Question 47

Sonographically, fat necrosis appears as an irregular, complex mass with low -level echoes, may mimic a(n) ________ lesion, and may appear as fat, but is separate and different from the rest of the breast parenchyma.

Answer 47

malignant