Chapter 21 PT 2 Flashcards
the breast is a modified ______ gland located in the superficial 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 _______.
subcutaneous, mammary, and 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.
upperouter
each lobule 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 cancer appear ______ and can be difficult to differentiate from the normal breast tissue.
hypoechoic
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 this time of development, the ductal system proliferates under the influence of ______.
estrogen
during pregnancy, acinar development is accelerated to enable milk production by estrogen, ______, and prolactin.
progesterone
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 the birth of a baby causes a drop in circulating progesterone, initiating ______ production within the breast.
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 purpose in ______ breasts that are ______ and difficult to penetrate by mammography, to evaluate masses.
young, dense
ultrasound is also useful in ______ structures within uniformly dense breast tissue where mammography is limited.
differentiating
a ______ aspiration can be performed to determine whether a lesion is a complex cyst or truly a solid mass.
cyst
what basic clinical information must the sonographer have for any patient referred for breast ultrasound?
patients age, risk factor for cancer, symptoms, location and clinical impression of lumps
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 ______, smooth, soft, and easily moveable.
round or 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, and fixed or poorly moveable.
irregular
most breast masses that arise during the adolescent years are ______.
fibroadenomas
an ______ 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 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 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.
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.
malignancies
to be considered a simple cyst, a lesion must meet which three criteria on ultrasound?
devoid of internal echoes, smooth inner margins within capsule, posterior acoustic enhancement
discuss the disruption of breast architecture with both benign and malignant tumors of the breast.
benign usually are slow growing and do not invade surrounding tissue, tend to grow horizontally
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 ______ orientation when imaging the breast from anterior to posterior.
vertically
if a mass measures longer in the anteroposterior dimension (______) then in either transverse or sagittal planes (______), the mass has a vertical orientation that is usually described as being “taller than wide” 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 tumor are rubbery, ______, and well delineated, 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.
fibrocystic conditions
the growth of a fibroadenoma is stimulated ______.
estrogen
sonographically, fat necrosis appears as an irregular, complex mass with low-level echoes, may mimic a ______ lesion, and may appear as fat, but is separated and difficult from the rest of the breast parenchyma.
malignant
______ may result from infection, trauma, mechanical obstruction in the breast ducts, or from other conditions.
acute mastitis
an intraductal papilloma is a small, ______ tumor that grows within the acini of the breast.
benign
in ______ tissue, most cancer growth occurs along the borders.
fibrotic
______ and ______ are frequently used as pathways for new tumor development.
lymphatics and blood vessels
if the tumor is ______ is continues to grow in one area, compressing and distorting the surrounding architecture.
encapsulated
most cancer originates in the ______ ductal lobular units, whereas a smaller percentage originates in the glandular tissue.
terminal
______ refers to breast tumors that arise from the epithelium, in the ductal and glandular tissue, and usually have tentacles.
carcinoma
breast carcinomas are generally categorized by two factors: where the cancer cells originate (______ or ______) and whether the cancer is prone to spreading (______ or ______).
ductal or lobular, noninvasive or invasive
carcinomas that do not normally spread outside of the duct or lobule are called noninvasive, noninfiltrating, or ______ cancers, whereas cancers that spread into nearby tissue are said to be invasive or infiltrating.
in situ
