Ch 21 Breast- Fill in the Blank Flashcards
The breast is a modified ________ gland located in the superfical fascia of the anterior chest wall.
sweat
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.
subcutaneous, mammary, retromammary
Fat is the least ________ tissue within the breast.
echogenic
The fatty tissue appears _______, whereas the ducts, glands, and supporting ligaments appear echogenic.
hypoechoic
The ________ quadrant of the breast contains the highest concentration of lobes.
upper outer
Each lobe contains _______ (milk-producing glands) that are clustered on the terminal ends of the ducts like grapes on a vine.
acini
The ________ muscle lies posterior to the retromammary layer.
pectoralis major
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.
adipose or fatty
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.
hyopechoic
The main arterial supply to the breast comes from the internal ________ and the lateral ________ artery.
mammary, thoracic
Lymphatic drainage from all parts of the breast generally flows to the _______ lymph nodes.
axillary
The primary function of the breast is _______ transport .
fluid
The _______ system is critical in the transport of fluids within the breast.
ductal
An important function during the reproductive years is for the breast to make ______ from nutrients and water taken from the bloodstream.
milk
Milk is produced within the ________ and carried to the nipple by the ducts.
acini
Breast development begins before _________ and continues until the patient is approximately 16 years old.
menarche
During pregnancy, acinar development is accelerated to enable milk production by estrogen, _________, and prolactin.
progesterone
During this time of development, the ductal system proliferates under the influence of ________.
estrogen
The hormone produced by the pituitary gland that stimulates the acini to produce and excrete milk is called _______.
prolactin
The expulsion of the placenta after birth of a baby causes a drop in circulating progesterone, initiating ______ production within the breasts.
milk
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.
oxytocin
Full maturation of the acini occurs during lactation and is thought to be mildly protective against the development of breast _______.
cancer
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.
young, dense
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).
differentiating
A(n) ) _______ aspiration can be performed to determine whether a lesion is a complex cyst or truly a solid mass.
cyst
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 _______.
menstrual cycle
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.
round, oval
Fibroadenomas are usually similar in shape, but they are often quite firm and rubbery in consistency and _________ on ultrasound.
homogeneously solid
Breast cancer is usually lobular or _________ in shape, uneven in surface contour (sometimes gritty in texture), and fixed or poorly movable.
irregular
Most breast masses that arise during the adolescent years are ________.
fibroadenomas
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.
intracapsular
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.”
linguine
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.
radial/antiradial
________ tend to grow within the ducts and will often follow the ductal system in a radial plane, toward the convergence at the nipple.
malignances
A rounded or oval shape is usually associated with ______ lesions, whereas sharp, angular margins are associated with ________ lesions.
benign, malignant
The normal tissue planes of the breast are __________ oriented.
horizontally
Benign lesions tend to grow within the normal tissue planes, and their long axis lies ________ to the chest wall.
parallel
Malignant lesions are able to grow through the connective tissue and may have a(n) ________ orientation when imaging the breast from anterior to posterior.
vertical
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.
height, width
Malignant masses will often demonstrate increased _________ within the lesion and often have a feeder vessel, which can be identified with careful evaluation.
vascularity
Lesions more common to younger women are _______ disease and fibroadenomas.
fibrocystic
Older or postmenopausal women are more likely to have _________ papillomas, duct ectasia, and cancer.
intraductal
Skin dimpling or ulceration and nipple retraction nearly always result from _______.
cancer
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.
mobile
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.
fibrocystic condition
The growth of a fibroadenoma is stimulated ________.
estrogen
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.
malignant
