Lesson 3B (Part 2)

Question 1

What are chronic postsurgical US findings that are related to scar formation? (3)

Answer 1

1. Retraction
2. Dystrophic calcifications
3. Fat necrosis
   - lipophagic granuloma, oil cyst

Question 2

What happens if you move a patient with an oil cyst?

Answer 2

It will also move

Question 3

What can scar formation mimic?

Answer 3

Cancer

Question 4

How can fat necrosis and dystrophic calcifications appear on the sonogram?

Answer 4

Hypoechoic or hyperechoic irregular mass with acoustic shadowing

Question 5

What is needed for suspicious lesions? (3)

Answer 5

1. Serial ultrasounds
2. Mammograms
3. Biopsy

Question 6

What are male breasts mainly composed of?

Answer 6

Fat

Question 7

What do male breast not have that females do? (2)

Answer 7

1. Lobules

2. Coopers ligaments

Question 8

How do male breasts appear on US? (4)

Answer 8

1. Small nipple
2. Little subcutaneous fat
3. Lack of subareolar glandular development
4. Prominent pectoralis major muscle

Question 9

Gynecomastia

Answer 9

Is the abnormal enlargement of rudimentary male breast tissue

Question 10

What can gynecomastia be related to?

Answer 10

Steroid abuse or associated with hormonal treatments

- eg) prostate cancer therapies

Question 11

How can gynecomastia present itself?

Answer 11

As a retroareolar lump with or without pain

Question 12

How can gynecomastia present itself on US?

Answer 12

Hypoechoic with spiculations radiating away from the nipple

Question 13

Where does gynecomastia originate?

Answer 13

From the stromal or ductal elements of the breast

Question 14

How common is male breast cancer?

Answer 14

Very rare

- < 1%

Question 15

What is the most common cancer for male breasts?

Answer 15

Infiltrating or invasive ductal cancer

Question 16

How does male breast cancer show on US? (3)

Answer 16

1. Microcalcifications uncommon
2. Appear spiculated
3. Ill defined

Question 17

How many different shades of gray do you need in order to be delineate fine differences in tissue architecture?

Answer 17

256

Question 18

How is fat representing on breast images?

Answer 18

Medium gray

Question 19

What is the mean velocities for highly suspicious malignant breast masses?

Answer 19

25-40 cm/s

Question 20

What is the mean velocities for benign lesion breast masses?

Answer 20

< 20 cm/s

Question 21

What are breast US artifacts? (4)

Answer 21

1. Bayonet sign
2. Mirror image
3. Refractive Edge Shadowing
4. Partial Volume Effect or Volume Averaging

Question 22

Bayonet sign

Answer 22

Aspiration needle appears to be broken

- difference in speed of sound between breast and fluid in cyst

Question 23

Mirror image

Answer 23

Duplication of a complex lesion on both sides of a strong specular acoustic interface

Question 24

What is the speed of sound in the human body?

Answer 24

1540 m/sec

Question 25

What is the speed of sound in the breast?

Answer 25

1450 m/sec

Question 26

What is the speed of sound in silicone breast implants?

Answer 26

1000 m/sec

Question 27

What does differences in speed cause in the breast?

Answer 27

Artifacts

Question 28

Refractive Edge Shadowing

Answer 28

Shadows extend from the edges of a cystic breast mass due to refraction

Question 29

Partial Volume Effect or Volume Averaging

Answer 29

Fill in of cystic structures because echoes are detected outside of central beam axis