Quiz 3: Anatomy, Physiology, and Pathology of the Breast Flashcards
1
Q
what type of glands are mammary glands?
A
accessory glands of the female reproductive system
2
Q
what are mammary glands also sometimes referred to as?
A
modified sebaceous glands
3
Q
what are the mammary glands specialized to produce?
A
colostrum and milk
4
Q
what shape is the breast considered
A
spherical
5
Q
what muscle lies immediately below the breast?
A
pectoralis major muscle
6
Q
what muscle lies to the lateral aspect of each breast?
A
serratus anterior
7
Q
a thin flat triangular muscle that lies deep to the pectoralis major muscle and covers the serratus anterior and the external oblique muscles
A
pectoralis minor muscle
8
Q
runs from the lateral aspect of the breast across the mid-axillary line to the lower back
A
latissimus dorsi
9
Q
represents the lowest attachment of the breast to the anterior chest wall
A
inframammary fold
10
Q
the most lateral aspect of the breast
A
axillary tail
11
Q
also called the ‘Tail of Spence’
A
axillary tail
12
Q
a layer of adipose(fatty) tissue that separates the breast from the pectoral muscle
A
retromammary space
13
Q
what is seen on the medioloteral oblique(MLO) projection mainly, 20% of the time seen on the CC projection
A
retromammary space
14
Q
what is the exact location of the breast vertically?
A
the breast extends vertically from the clavicle at the 2nd or 3rd rib to meet the abdominal wall at the level of the 6th or 7th rib.
15
Q
what is the exact location of the breast medially?
A
the breast extends from the mid-sternum to the mid-axillary line and to the latissimus dorsi muscle, laterally
16
Q
what does the skin of the breast consist of?
A
sweat glands, sebaceous glands, and hair follicles
17
Q
what does the nipple crevices contain?
A
15-20 orifices, and ducts that transfer milk from the lactiferous ducts to the exterior
18
Q
the smooth, circular, darkened area surrounding the nipple
A
areola
19
Q
what are the many small protrusions called on the surface of the areola?
A
Morgani tubercles
20
Q
what ducts are opened by morgani tubercles?
A
Montgomery glands
21
Q
are specialized sebaceous-type glands found on the areola
A
Montgomery glands
22
Q
why do Montgomery glands secrete a fatty lubricant while breast feeding?
A
to protect the nipple during nursing
23
Q
what age (young or old) is areola pigmentation more prominent?
A
young
24
Q
when does pigmentation begin to fade in the areola of the breast?
A
at menopause
25
what will increase pigmentation of areola?
the use of estrogen
26
what quadrant does the 1st quadrant refer to?
upper outer quadrant (UOQ)
27
what quadrant does the 2nd quadrant refer to?
upper inner quadrant (UIQ)
28
what quadrant does the 3rd quadrant refer to?
lower outer quadrant (LOQ)
29
what quadrant does the 4th quadrant refer to?
lower-inner quadrant (LIQ)
30
what quadrant is the axillary tail in?
UOQ or 1
31
what are the 4 regions of the breast?
posterior, middle, anterior, subareolar
32
is closest to the chest wall
posterior region
33
refers to the middle of the breast
middle region
34
is located behind the nipple
anterior region
35
lies immediately behind the areola
subareolar
36
what 4 things is the breast made out of?
adipose(fatty) tissue, glandular(secretory) components, lymphatic vessels, and blood vessels
37
the fibrous and glandular tissues within the breast are generally described as ___________.
fibroglandular densities
38
what type of breast tissue do young women typically have?
glandular
39
what type of breast tissue do older women typically have?
fatty
40
what 3 ways can a breast lesion be described while being triangulated?
in terms of the face of a clock
4 quadrants
4 regions
41
what 3 terms is the upper outer quadrant (UOQ) also known as?
axillary tail
tail of the breast
tail of Spence
42
region closest to the chest wall
posterior region
43
region in the middle of the breast
middle region
44
region located behind the nipple
anterior region
45
region located immediately behind the areola
subareolar region
46
What are the tissues within the breast generally described as?
Fibroglandular Densities
47
What type of breast tissue predominates in younger woman?
Glandular tissue
48
What type of breast tissue predominates in older women?
Fatty tissue
49
How does fatty tissue show up on a mammogram?
Higher optical density areas
50
How does fibrous and glandular tissue show up as on a mammogram?
Lower optical density areas
51
Where is the most glandular breast tissue is found?
Centrally, extending laterally toward the axilla in the upper outer quadrant(UOQ)
52
Are fibrous brands that predominate in the upper part of the breast
Cooper ligaments
53
What is another term for Cooper ligaments?
Suspensory ligaments
54
Where does the breast receive it’s arterial supply from?
Axillary artery
55
A venous network formed from veins under the nipple
Circulus venosus
56
How does the blood supply appear on a radiographic image of the breast?
Low optical density structures
57
Are veins or arteries larger in the breast?
Veins
58
What are the name of the lymphatic vessels that drain the breast?
Superficial plexus and the deep plexus
59
What is the typical size of a lymph node?
2 cm
60
What type of shape does a lymph node typically take?
Kidney shaped
61
Which intercostal nerves serve the breast with sensory and sympathetic functions?
4th 5th & 6th
62
Describe the ductal system within the breast
Lobules deep within the breast, segmental/mammory ducts, nipple
63
How do the ducts change as they approach the nipple?
They gradually increase in size
64
What is the area immediately behind the nipple that is a pouch like orifice?
Ampulla or lactiferous sinus
65
What is a connecting duct between the nipple orifice in the ampulla?
Lactiferous duct
66
Where does milk production begin?
In lobules/terminal ductal lobular units (TDLU’s)
67
What part of the breast have the most rapidly dividing cells?
Terminal Ductile lobular units (TDLUs)
68
How many lobes will the average female breast eventually develop?
15 to 20 lobes
69
Contains a tree like pattern of ductal structures radiating out from the nipple
Each lobe of the breast
70
what are the fibrous and glandular tissues within the breast generally described as?
fibroglandular densities
71
Name some factors that affect breast tissue
Menarche, hormonal fluctuations, pregnancy, lactation, genetic predisposition, or menopause.
72
what factors affect breast tissue composition?
menarche, hormonal fluctuations, pregnancy, lactation, menopause, genetic predeposition
73
When does the female breast start to form?
when the ovaries begin to produce estrogen and progesterone
74
what is the first mensus called?
menarche
75
the hormone responsible for ductal proliferation
estrogen
76
the hormone responsible for lobular proliferation and growth
progesterone
77
how soon before a woman's period can breast changes occur? and how long until they go back to normal?
3-4 days before, 5-10 days after.
78
lactation is made possible by the hormone called ______ and by secretions from the ________.
prolactin; adrenal cortex
79
what is the overall effect of lactation on the breast?
denser and larger breast
80
the term used to indicate pregnancy being carried to a point of viability (24-26 weeks of gestation) regardless of the outcome
parity
81
the time of a woman's life where glandular, supportive, and connective tissue are replaced by fatty tissue
involution
82
when is menopause considered to have started?
period free with no spotting, being pregnant, breastfeeding, taking medications, or having undergone surgery for at least 1 year.
83
when can menopause normally occur
between ages 45-54
84
what are positive effects of HRT (Hormone Replacement Therapy)?
alleviates most of the symptoms of menopause and can prevent osteoporosis-related fractures
85
what are negative effects of HRT (Hormone Replacement Therapy)?
cause an increase in the size of fibroadenomas and the development or increase in the size of cysts in the breast which can mimic carcinoma
86
the process of increasing the size of the breast
augmentation
87
what is the only way a lesion can be classified?
through a histological or cytological analysis
88
What are 4 characteristics of benign lesions?
Circumscribed, radiolucent, radiolucent and radiopaque combined, halo sign
89
Circular or oval in size/shape with smooth borders
Circumscribed benign lesion
90
What are the 2 most common circular or oval lesions?
Cysts and fibroadenomas
91
This type of benign lesion are often symptomatic and are detected by the patient as a palpable mass
Circumscribed benign lesion
92
In these lesions, the surrounding parenchymal structures can be seen through the lesion
Radiolucent benign lesions
93
It may be more difficult to visualize the parenchymal structures through these lesions
Radiolucent and radiopaque combined benign lesions
94
What are 4 different characteristics of malignant lesions?
Spiculated borders, irregular or obscured borders, multiple lobulated and randomly orientated, radiopaque and highly radiopaque
95
These are a strong indication for malignancy
Spiculated borders malignant lesions
96
Benign lesions, such as postoperative fibrosis, fat necrosis, abscess, and hematomas, can mimic ___________.
Spiculated lesions
97
In-drawing or renting of the breast parenchyma can be a sign of
Malignancy
98
Radiolucent or radiopaque and any combination in between
Optical density
99
Placement of the calcification in the breast
Distribution
100
Variation in optical density, distribution, number, morphology, or size over time
Change over time
101
Calcifications >0.5 in diameter
Coarse
102
Calcifications >1 mm in diameter and often associated with ducts
Linear or rod-like
103
If the calcifications are <0.5 mm in diameter
Round or punctuate
104
Fine, linear, or branching calcifications that can be fragmented with irregular contours and are often malignant
Casting type
105
Calcifications forming multiple flake-like irregular clusters that can be microcalcifications or macrocalcifications and typically of immediate concern
Amorphous or indistinct
106
Calcification of different shapes, irregular in form, size, and optical density and are typically malignant
Pleomorphic or granular
107
Smooth contours, high uniform optical density benign breast calcification appearance
Plasma cell mastitis
108
Evenly scattered homogenous benign breast calcification appearance
Calcifies arteries
109
Sharply outlined, spherical or oval benign breast calcification appearance
Oil cysts
110
Pear-like densities resembling teacups or pearl drops on the lateral projection benign breast calcification appearance
Milk of calcium
111
Bilateral and evenly scattered following the course of the ducts throughout much of the parenchyma benign breast calcification appearance
Plasma cell mastitis
112
Ring-like, hollow benign breast calcification appearance
Sebaceous gland Calcifications
113
Eggshell-like benign breast calcification appearance
Oil cyst, papilloma
114
Large bizarre size benign breast calcification appearance
Hemangiomas
115
Calcifications on the skin
Dermal Calcifications
116
This condition can produce Calcifications that tend to be linear and segmental but are sometimes malignant appearing
Sclerosis adenosis or ductal hyperplasia
117
Produces large Calcifications, whether Periductal or intraductal, and are the result of secretions within dilated ducts
Ductal ectasia or plasma cell mastitis
118
Where do the majority of breast diseases occur?
TDLUs
119
What are the 2 main classifications of breast cancer
Ductal carcinoma and lobular carcinoma
120
Is the most common breast cancer, accounting for about 90% of all breast cancers
Ductal carcinoma
121
Accounts for 5% to 10% of all breast cancers
Lobular carcinoma
122
The cancer is confined to the duct and does not invade the duct walls
Ductal carcinoma in situ (DCIS)
123
This is commonly referred to as stage 0 carcinoma
Ductal carcinoma in situ (DCIS)
124
The cancer has spread from the ducts into the surrounding stromal tissue and may or may not extend into the pectoral fascia and muscle
Invasive or infiltrating ductal carcinoma (IDC)
