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Summer Test 1 > Chapter 21 Breast > Flashcards

Chapter 21 Breast Flashcards

1
Q

acinus (acini)

A

Glandular (milk-producing) component of the breast lobule

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2
Q

areola

A

The pigmented skin surounding the breast nipple

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3
Q

axilla

A

armpit

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4
Q

breast

A

differentiated apocrine sweat gland with a functional purpose of secreting milk during lactation

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5
Q

Cooper’s ligaments

A

connective tissue septa that connect perpenndicularly to the breast lobules and extend out to the skin

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6
Q

mammary layer

A

middle layer of the breast tissue that contains the ductal, glandular, and stromal portions of the breast

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7
Q

retromammary layer

A

deepest of the three layers of the breast noted on breast ultrasound

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8
Q

subcutaneous layer

A

most superficial of the three layers of the breast identified on breast ultrasound

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9
Q

tail of Spence

A

normal extension of breast tissue into the axillary region

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10
Q

The primary function of the breast is ______ transport.

A

fluid

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11
Q

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

A

ductal

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12
Q

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

A

milk

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13
Q

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

A

acini

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14
Q

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

A

menarche

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15
Q

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

A

estrogen

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16
Q

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

A

progesterone

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17
Q

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

A

prolactin

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18
Q

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

A

milk

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19
Q

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.

A

oxytocin

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20
Q

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

A

cancer

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21
Q

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

A

young, dense

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22
Q

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).

A

differentiating

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23
Q

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

A

cyst

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24
Q

What basic linical information must the sonographer have for any patient referred for breast ultrasound?

A

patients age, risk factors for breast cancer, symptoms, location and clinical impression of any lumps

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25
Q

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

A

menstral cycle

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26
Q

The breast is a modified _______ gland located in the superfiial fascia of the anterior chest wall.

A

sweat

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27
Q

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.

A

subcutaneous, mammary, retromammary

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28
Q

Fat is the least __________ tissue within the breast.

A

echogenic

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29
Q

The fatty tissue appears ______, whereas the ducts, glands, and suporting ligaments appear echogenic.

A

hypoechoic

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30
Q

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

A

upper outer

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31
Q

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

A

acini

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32
Q

The _________ muscle lies porterior to the retromammary layer.

A

pectoralis major

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33
Q

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

A

adipose or fatty

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34
Q

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.

A

hyoechoic

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35
Q

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

A

mammary, thoracic

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36
Q

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

A

axillary

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37
Q

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

A

round, oval

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38
Q

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

A

homogeneously solid

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39
Q

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

A

irregular

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40
Q

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

A

fibroadenomas

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41
Q

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

A

inracapsular

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42
Q

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

A

linguine

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43
Q

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

A

radial/antiradial

44
Q

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

A

Malignancies

45
Q

To be considered a simple cyst, a lesion must meet which three criteria on ultrasound?

A

Must be devoid of internal echoes (anaechoic), show smooth inner margins with an imperceptible capsule, and demonstrate posterior acoustic enhancement.

46
Q

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

A

benign, malignant

47
Q

The normal tissue planes of the breast are ______ oriented.

A

horizontally

48
Q

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

A

parallel

49
Q

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

A

vertical

50
Q

If a mass measure 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.

A

height, width

51
Q

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

A

vascularity

52
Q

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

A

fibrocystic

53
Q

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

A

intraductal

54
Q

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

A

cancer

55
Q

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

A

mobile

56
Q

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

A

fibrocystic condition

57
Q

The growth of a fibroadenoma is stimulated __________.

A

estrogen

58
Q

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.

A

malignant

59
Q

____________ may result from infection, trauma, mechanical obstruction in the breast ducts, or from other conditions. It often occurs during lactation, beginning in the lactiferous ducts and spreading via the lymphatics or blood.

A

acute mastitis

60
Q

An intraductal papilloma is a small, ________ tumor that grows within the acini of the breast.

A

benign

61
Q

In ________ tissue, most cancer growth occurs along the borders.

A

fibrotic

62
Q

_________ and _________ are frequently used as pathways for new tumor development.

A

lymphatics, blood bessels

63
Q

If the tumor is __________, it continues to grow in one area, compressing and distorting the surrounding architecture.

A

encapsulated

64
Q

Most cancer originates in the ________ ductal lobular units, whereas a smaller percentage originates in the glandular tissue.

A

terminal

65
Q

___________ refers to breast tumors that arise from the epithelium, in the ductal and glandular tissue, and usually have tentacles.

A

Carcinoma

66
Q

Breast carcinomas are generally categorized by two factors: where the cancer cells originate (___________ or ___________) and whether the cancer is prone to spreading (___________ or __________).

A

ductal, lobular, noninvasive, invasive

67
Q

Carcinomas that do not normally spread outside of the duct or lobule are called noninvasive, noninfiltrating, or _______ caners, whereas cancers that spread into nearby tissue are said to be invasive or infiltrating.

A

in situ

68
Q

antiradial

A

plane of imaging on ulrasound of the breast that is perpendicular to the radial plane of imaging

69
Q

asymptomatic

A

without symptoms

70
Q

breast imaging reporting and data system

A

trademark system created by the American College of Radiology (ACR) to standardize mammographic reporting terminology, categorize breast abnormalities according to the level of suspicion for malignancy, and facilitate outcome monitoring

71
Q

breast self-examination

A

part of breast cancer screening best done at the end of menses each month

72
Q

clinical breast examination

A

part of breast cancer screening done by a health care provider

73
Q

diagnostic breast imaging

A

type of breast imaging examination that is more intensive than routine screening mammography

74
Q

fremitus

A

refers to vibrations produced by phonation and felt through the chest wall during palpation

75
Q

juxtathoracic

A

near the chest wall

76
Q

hyperechoic

A

echo texture that is more echogenic than the surrounding tissue

77
Q

palpable

A

can be felt on clinical examination

78
Q

isoechoic

A

echotexture that resembles the surrounding tissue

79
Q

radial

A

plane of imaging on ultrasound of the breast

80
Q

sentinel node

A

represents the first lymkph node along the axillary node chain

81
Q

spiculation

A

finger-like extension of a malignant tumor

82
Q

nonpalpable

A

cannot be felt on clinical examination

83
Q

anechoic

A

without echoes

84
Q

hypoechoic

A

having relatively weak echoes

85
Q

cyst aspiration

A

common diagnostic and interventional procedure that involves placing a needle through the skin of the breast into a cystic mass and pulling fluid out of the cyst through the needle

86
Q

breast cancer screening

A

preventive care that includes annual screening mammography (starting at age 40), monthly breast self-examination, and regular clinical breast examination

87
Q

adenosis

A

overgrowth of the stromal and epithelial elements of the acini within terminal ductal lobular unit (TDLU) of the breast

88
Q

apocrine metaplasia

A

form of fibrocystic change in which the epithelial cells of the acini undergo alteration

89
Q

atypical ductal hyperplasia

A

the pathologist recognizes some, but not all, of the features of ductal carcinoma in situ

90
Q

atypical hyperplasia

A

abnormal proliferation of cells with atypical features involving the TDLU, with an increased likelihood of evolving into breast cancer

91
Q

atypical lobular hyperplasia

A

shows, some, but not all, of the features of lobular carcinoma in situ

92
Q

cyst

A

fluid-filled sac of varible size

93
Q

epithelial hyperplasia

A

proliferation (hyperplasia) of epithelial cells lining the terminal duct-lobular unit

94
Q

fibroadenoma

A

most common benign solid tumor of the breast, consisting primariy of fibrous and epithelial tissue elements

95
Q

fibrocystic condition

A

condition that represents different, essentially normal, tissue processes within the breast that in some patients become exaggerated to the point of raising concern for breast cancer

96
Q

Paget’s disease

A

surface erosion of the nipple characterized by redness with flaking and crusting caused by direct invasion of the skin of the nipple by underlying breast cancer

97
Q

peau d’ orange

A

descriptive term for skin thickening of a breast that resembles the skin of an orange

98
Q

infiltrating ductal carcinoma

A

cancer of the ductal epithelium; most common general category of breast cancer, accounting fro approximately 85% of all breast cancers

99
Q

infiltrating lobular carcinoma

A

cancer of the lobular epithelium of the breast, arises at the level of the TDLU

100
Q

isoechoic

A

echo texture that resembles the surrounding tissue

101
Q

lobular carcinoma in situ

A

neither considered a true cancer nor treated as such

102
Q

lobular neoplasia

A

term preferred by many authors to replace LCIS and atypical hyperplasia

103
Q

multicentric breast cancer

A

breast cancer occurring in different quadrants of the breast at least 5 cm apart

104
Q

multifocal breast cancer

A

breast cancer occurring in more than one site within the same quadrant of the same ductal system of the breast

105
Q

breast cancer

A

involves two main types of cells (ductal and lobular)

106
Q

gynecomastia

A

hypertrophy of residual ductal elements that persist behiing the nipple in the male

Summer Test 1 (3 decks)

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