Breast

Question 1

What mnemonic is used to identify a simple cyst?

Answer 1

STAR: Smooth & Thin Walled, Through transmission, Anechoic, Round

Question 2

What characterizes a complex cyst?

Answer 2

Cystic with a solid component, may have thick, irregular walls, internal echoes, and lack of through transmission

Question 3

What is an oil cyst?

Answer 3

Liquification of injured fat, usually from trauma or surgery, palpable & smooth, usually anechoic, possible hyperechoic internal echoes

Question 4

What is a galactocele?

Answer 4

Milky cyst that forms from obstruction of the lactiferous ducts during pregnancy or lactation, usually presents as periareolar palpable masses

Question 5

What is a sebaceous cyst?

Answer 5

Retention cyst from blockage of a sebaceous gland in the skin, not specific to breast, small, superficial, smooth, and palpable

Question 6

What are the benign characteristics of breast neoplasms?

Answer 6

Wider than tall, parallel to the skin, well circumscribed, thin walled, through enhancement

Question 7

What is a fibroadenoma?

Answer 7

Most common benign mass in premenopausal women, stimulated by estrogen, usually identified in women younger than 30

Question 8

What is cystosarcoma phylloides?

Answer 8

A type of fibroadenoma, usually seen in women ages 30-40, characterized by rapid growth and cystic spaces

Question 9

What does intraductal papilloma involve?

Answer 9

Proliferation of epithelial tissue within a duct or cyst, typically small and retroareolar

Question 10

What are the characteristics of a lipoma?

Answer 10

Not specific to the breast, usually unilateral, soft, mobile, compressible, and palpable

Question 11

What is a hamartoma?

Answer 11

Also known as fibroadenolipomas, large, soft, mobile, painless, and palpable, generally ovoid

Question 12

What are the malignant characteristics of breast cancer?

Answer 12

Taller than wide, painless, perpendicular to the skin, stone hard, irregular, spiculated

Question 13

What is invasive ductal carcinoma?

Answer 13

Accounts for 65-80% of breast cancers, originates from lactiferous ducts, characterized by hypoechoic appearance and sharp angulations

Question 14

What is the peak age for invasive lobular carcinoma?

Answer 14

55 to 70 years old, bilateral in 21% of cases, characterized by infiltrating and significant posterior shadowing

Question 15

What is colloid carcinoma also known as?

Answer 15

Mucinous or gelatinous carcinoma, prevalent in women 60-70 years old, usually hypoechoic

Question 16

What defines medullary carcinoma?

Answer 16

Fast growing, good prognosis, mobile, hypoechoic, round, well marginated

Question 17

What is the peak age for papillary carcinoma?

Answer 17

63-67 years old, often found in the retroareolar area

Question 18

What is comedocarcinoma?

Answer 18

Intraductal carcinoma with nipple retraction, dominant mass, and irregular margins

Question 19

What characterizes Paget’s disease?

Answer 19

Retroareolar growth with a rash-like appearance, typical in women over 50, irregular margins

Question 20

What is scirrhous carcinoma?

Answer 20

Intraductal tumor with extensive fibrous tissue, very firm, non-moveable mass, often causing nipple retraction

Question 21

What is mastitis?

Answer 21

Inflammation of the breast during lactation, characterized by warmth, redness, tenderness, and possible nipple discharge

Question 22

What are the characteristics of an abscess?

Answer 22

Usually retroareolar, occurs during lactation or weaning, complex mass with irregular thick walls

Question 23

What is gynecomastia?

Answer 23

Most common male breast anomaly, enlargement from benign ductal & stromal proliferation occurring in three stages

Question 24

What is the purpose of cyst aspiration?

Answer 24

Determines if a lesion is complex vs solid

Question 25

What is the purpose of needle wire localization?

Answer 25

Placement of needle wire for preoperative localization of nonpalpable breast lesions

Question 26

What does a large core needle biopsy involve?

Answer 26

Guidance of large core needle biopsy of solid masses

Question 27

What is a sentinel node biopsy?

Answer 27

Standard surgical therapy for full level I and partial level II axillary lymph node dissection

Question 28

What is the 'stepladder sign' associated with?

Answer 28

Intracapsular rupture of a breast implant

Question 29

What is the lifetime risk of developing breast cancer for women?

Answer 29

12% ## Footnote One in eight women will develop breast cancer

Question 30

What is the most common cancer among women in the US?

Answer 30

Breast cancer

Question 31

What is the second leading cancer among women aged 40 to 59?

Answer 31

Breast cancer

Question 32

What type of gland is the breast classified as?

Answer 32

Modified sweat gland

Question 33

What is the Tail of Spence?

Answer 33

Extension of breast tissue into the lateral upper margin of the chest into the axilla

Question 34

How many lobes does the functional portion of the breast contain?

Answer 34

15-20 lobes

Question 35

Where are most breast tumors typically found?

Answer 35

Upper outer quadrant of the breast

Question 36

What are TDLUs?

Answer 36

Terminal ductal lobular units

Question 37

Where does nearly all pathology within the breast originate?

Answer 37

TDLUs (terminal ductal lobular units)

Question 38

How many new cases of male breast cancer are diagnosed annually?

Answer 38

Approximately 1300 new cases

Question 39

What percentage of breast cancer cases are found in men?

Answer 39

Approximately 1% of incidence in women

Question 40

What does subcutaneous fat typically appear as in breast imaging?

Answer 40

Hypoechoic

Question 41

What is the appearance of retromammary tissue compared to subcutaneous tissue?

Answer 41

Similar in texture, with boundary echoes resembling skin

Question 42

What confirms whether a mass is adipose tissue or a true mass?

Answer 42

Turning 90 degrees on the questionable area

Question 43

What changes occur in the glandular tissue of women as they age?

Answer 43

Glandular tissue undergoes cell death and is replaced by infiltrated fatty tissue

Question 44

What is the primary function of the breast?

Answer 44

To transport fluid

Question 45

When should a Self Breast Exam (SBE) be performed?

Answer 45

At the end of menses, beginning at age 20

Question 46

What is the purpose of the Clinical Breast Exam (CBE)?

Answer 46

Performed once every 3 years, yearly after age 40

Question 47

What does BI-RADS stand for?

Answer 47

Breast Imaging Reporting and Data System

Question 48

What percentage of screening mammograms will have abnormalities?

Answer 48

10%

Question 49

When is breast ultrasound indicated?

Answer 49

In patients under age 30, with risk factors, or clinical impression of lumps

Question 50

What are the two scanning planes used in breast ultrasound?

Answer 50

* Radial Scanning Plane * Anti-Radial Scanning Plane

Question 51

What is the 'step-ladder sign' or 'linguini sign' indicative of?

Answer 51

Ruptured breast implant

Question 52

What does the 'snowstorm sign' indicate?

Answer 52

Extracapsular leakage from a breast implant

Question 53

What are common types of breast masses?

Answer 53

* Fibroadenoma * Breast Cysts * Breast Cancer

Question 54

As women age, which type of breast tissue decreases?

Answer 54

Fibrous tissue

Question 55

What is the lymphatic drainage pattern for the breast?

Answer 55

97% to axillary lymph nodes, 3% to internal chain