Lesson 3C (Part 2) Flashcards
FCC
Fibrocystic Change
What is the most common benign diffuse breast condition?
Fibrocystic Change
What are the symptoms of FCC? (3)
- Breast tenderness
- Fullness
- Nodularity
What age group does FCC typically occur in?
35-50
How does FCC appear on US? (2)
- Multiple cysts of varying sizes in both breasts
2. Fibroglandular tissue
Fibroglandular tissue
Basket weave appearance with ductal prominence
What is related to FCC?
Simple cysts
What are simple cysts a result from?
Dilatation and effacement of the terminal duct lobular unit
What is the most common cause of breast lumps for 35-50 year old women?
Simple cysts
- single or multiple
How can a cysts be classified as simple?
It must satisfy all the sonographic criteria set forth
- anechoic
- well circumscribed
- thin echogenic capsule
- increased through-transmission
- thin edge shadows
What happens once a mass meets all the criteria for a simple cyst?
It is classified as BI-RADS 2
What is considered to be a complicated cyst?
A cyst that meets all the criteria of a simple cyst except that it contains low-level internal echoes or fluid–fluid or fluid–debris levels that can shift with changes in the patient’s position
What are causes of internal echoes? (6)
- Cell debris
- Protein
- Cholesterol
- Blood
- WBCs
- Epithelial cells
Complex cysts
A cyst with thick walls or some discrete solid component
- eg) septa greater than 0.5 mm thick or mural nodules
What is the differential diagnosis for a cyst with a mural nodule? (4)
- intracystic papilloma
- Atypical ductal hyperplasia
- Ductal carcinoma in situ
- Papillary carcinoma
What is the differential diagnosis for a complex cyst? (5)
- Hematoma
- Fat necrosis
- Abscess
- Galactocele
- Necrotic neoplasm
What kind of cyst is it if it is mobile?
Complicated cyst
What kind of cyst is it if it is not mobile?
Fixed cyst
What is the most common benign mass to develop in a lactating patient?
Galactocele
Where does galactocele form from?
The accumulation of milk distal to an obstruction in the terminal ductal unit
How does galactocele appear on the US? (2)
- Round or oval circumscribed mass
2. Uni or multi lobular
What determines the mammographic and sonographic appearances for galactocele?
The age of the milk products contained in the galactocele
What happens as the age of the milk products contained in the galactocele ages?
The cyst increases in complexity
What do complex cysts develop? (2)
- Echogenic foci
- due to separation of the fat components - Fat–fluid levels with the echogenic component layering in the nondependent portion
What happens when the milk curdles in a galactocele?
Leads to the development of a solid component within the cyst
- appearing as a solid echogenic mass
What can galactocele become?
Lipid (oil) cysts
Sebaceous cysts
Small, benign skin appendage masses that result from obstructed sebaceous glands
Where are sebaceous cysts located?
Inferior or medial margins of breast or near axilla
What is the shape and margins of a sebaceous cysts? (2)
- Shape = round or oval
2. Margin = smooth with thin wall circumscribed margins
What is the echogenicity of sebaceous cysts? (3)
- Anechoic
- Internal echoes
- Fluid fat levels
What are 2 sonographic appearances of sebaceous cysts?
- Focal skin thickening
- Clawlike appearance
- cyst projects into subcutaneous fat
