Breast

Question 1

Which breast layer is functional portion of the breast

Answer 1

mammary

Question 2

What is the collective name of the connective tissue septa, which forms a fibrous “skeleton” that maintains the shape and structure of the breast

Answer 2

cooper’s ligaments

Question 3

What is the echogenicity of fat within the breast

Answer 3

Hypoechoic

Question 4

List the layers of the breast from superficial to deep

Answer 4

Subcutaneous
mammary
retromammary

Question 5

Where is the pectoralis muscle located

Answer 5

posterior to the retromammary layer

Question 6

Describe the parenchymal pattern of the breast tissue sonographically based on age: YOUNG

Answer 6

fibrous-dense echogenic pattern

Question 7

Describe the parenchymal pattern of the breast tissue sonographically based on age: PREGNANT/LACTATING

Answer 7

larger, more dense glandular

Question 8

Describe the parenchymal pattern of the breast tissue sonographically based on age: MATURE/OLDER

Answer 8

fatty replacement of glandular

Question 9

Describe the parenchymal pattern of the breast tissue sonographically based on age: POSTMENOPAUSAL

Answer 9

ducts atrophy

less fibrous tissue

Question 10

What tool can be used to improve loss of detail of superficial structures within the breast when performing an ultrasound exam

Answer 10

stand-off pad

Question 11

What 2 arteries supply the breast

Answer 11

internal mammary gland

lateral thoracic artery

Question 12

Venous drainage of the breast is provided mainly by which veins

Answer 12

superficial veins

Question 13

Is it possible to have lymph node involvement from breast cancer

Answer 13

yes

Question 14

At what age is it currently recommended that women should have an annual screening mammogram

Answer 14

40 years of age

Question 15

List 5 factors for breast cancer

Answer 15

female gender
increasing age
family or personal history of breast cancer
premenopausal breast cancer
associated cancers

Question 16

The physiology of the breast is affected by changing hormonal levels during what 3 processes

Answer 16

menstrual cycle
pregnancy
lactation

Question 17

List 4 clinical signs/symptoms of possible breast cancer

Answer 17

new or growing dominant
discrete breast lump
does not fluctuate w hormone cycle
unilateral single duct nipple discharge

Question 18

What type of breast mass is more suspicious for cancer, one that is wider than tall or taller than wide

Answer 18

taller than wide

Question 19

List reasons why a breast sonogram may be ordered

Answer 19

further characterization of mammographic masses
evaluation of a palpable breast lump
young pt w dense breasts
pregnant or lactating pt
pt w breast aug
difficult/compromised mammo
image guided procedures

Question 20

List the 4 lesion location methods

Answer 20

distance from nipple
clock face
ABC/123
quadrant

Question 21

Regarding the characteristics of a solid malignant mass there may be

Answer 21

nipple retraction

dimpling of the skin

Question 22

List 2 sonographic characteristics of a solid malignant mass, with regard to mass orientation

Answer 22

taller than wide

radial growth

Question 23

What are the 3 possible differential diagnosis of a palpable breast lumo with negative breast imaging

Answer 23

fibrocystic condition
resolving trauma
cancer

Question 24

List 3 sonographic characteristics of a solid malignant mass, with regard to mass margins

Answer 24

indistinct
fuzzy
spiculated

Question 25

Describe the difference in the disruption of breast architecture by a benign versus a malignant solid mass

Answer 25

Benign- grows within tissue causing compression of the tissue adjacent to the mass Malignant- grows through tissue without compressing adjacent tissue (may cause nipple retraction or skin dimpling)

Question 26

List 3 sonographic characteristics of a solid malignant mass, with regard to mass shape

Answer 26

sharp angular microlobulations

Question 27

In contrast what are the 3 characteristics of the shape of a benign mass

Answer 27

rounded or oval | large lobulations

Question 28

Which is more suspicious of a solid breast mass sonographically, a mass that is isoechoic, compared to the surrounding tissues or a mass containing clusteres microcalcifications

Answer 28

clustered microcalcifications

Question 29

Which of the following is more suspicious of a solid breast mass sonographically, a mass with some mobility or one that is firmly fixed and moves adjacent tissue

Answer 29

firmly fixed

Question 30

benign condition that results in symptoms that represent normal physiologic processes of breast tisse that fluctuate under the influence of normal female hormonal cycles

Answer 30

fibrocystic condition

Question 31

What are 3 categories of fibrocystic condition

Answer 31

no-proliferative proliferative lesions without cellular changes proliferative lesions with atypical cellular changes

Question 32

What is the more common benign breast tumor

Answer 32

fibroadenoma

Question 33

Which benign breast lesion consists of fatty tissue with fibrous and glandular elements

Answer 33

lipoma

Question 34

Fat necrosis is caused by

Answer 34

trauma surgery radiation treatments plasma cell mastitis

Question 35

What is the initial treatment for acute mastitis

Answer 35

antibiotics

Question 36

What age group is chronic mastitis usually seen on

Answer 36

elderly women

Question 37

What are the clinical findings of a breast abscess

Answer 37

pain swelling and reddening of skin possible fever swollen axillary lymph nodes

Question 38

Can a definite diagnosis of breast abscess be made without aspiration

Answer 38

no

Question 39

What is the most common symptom of intraductal papilloma

Answer 39

nipple discharge arising from a single duct

Question 40

What fruit like appearance is intraductal papilloma said to have on mammo

Answer 40

rasberry

Question 41

Which quadrant of the breast is cancer most often found in

Answer 41

upper-outer

Question 42

List 2 main types of breast cancer and tell where they arise from

Answer 42

sarcoma- supportive or connective tissue | carcinoma- from the epithelium in the ductal or glandular tissue

Question 43

Where do the majority of breast cancers begin

Answer 43

within the ducts

Question 44

Cancers that spread outside the duct are referred to as

Answer 44

invasive or infiltrating

Question 45

What does the term in situ mean

Answer 45

within the ducts- have not spread through the walls into other breast tissue

Question 46

Which malignancy accounts for nearly 80% of breast cancers and has the potential to metastasize via the bloodstream or lymphatic system

Answer 46

invasive ductal carcinoma

Question 47

invasive lobular carcinoma begins in the _______ and extends into the fatty tissue, is often bilateral,

Answer 47

lobule multicentric multifocal

Question 48

Describe multifocal

Answer 48

more than 1 tumor identified, located within the same quadrant or ductal system and within 5 cm of each other, usually same cell type

Question 49

Describe multicentric

Answer 49

located in different quadrants and at least 5 cm apart, usually different cell types

Question 50

malignant breast legion that results in the lactiferous ducts being filled with a yellow paste-like material

Answer 50

comedocarcinoma

Question 51

Paget's disease typically affects women of what age group

Answer 51

over 50 years of age

Question 52

List 4 interventional breast procedures that utilize ultrasound guidance

Answer 52

cyst aspiration fine needle drainage procedures sentinel node biopsy needle localization

Question 53

List 3 reasons a drainage procedure would be performed for a breast

Answer 53

breast abscess seroma hematoma

Question 54

What is the purpose of a sentinel node biopsy

Answer 54

To assess lymph node metastasis involvement of breast cancer