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Breast Flashcards

(54 cards)

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0
Q

Indications

A

Used as an adjunct to mammography, a target rather than screening.

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1
Q

Second leading cause of cancer deaths in women next to lung cancer

A

Breast cancer.

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2
Q

Ultrasound vs Mammography

A

Mammo sees tiny micro Ca+

Mammo has hard time imaging dense breast

Ultrasound differentiates cystic vs solid

US characterizes a palp mass

US can assess with trauma,inflammation,augmentation

US guided cyst aspiration

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3
Q

Breast anatomy

A

Paired mammary glands containing fatty glandular and fibrous connective tissue

Parenchyma has 15-20 lobes, further divided into 20-40 lobules

Each lobe has a lactiferous duct 15-20 that converge at the nipple and enlg with lactation

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4
Q

Terminal duct lobular unit TDLU

A

< 2 mm, where most Breast pathology arises

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5
Q

Benign

A 
Lesion won't cross fibrous plane 
Well defined
Well circumscribed 
Smooth 
Mild lobulations 
Thin
Echogenic pseudocapsule
Round
Ovoid
Horizontal 
Wider than tall
Uniform
Hypoechoic 
Anechoic
Homogeneous
Non attenuating
Enhancement with cyst
Compressible
Mobile 
Fluid-filled lacks flow
Solid masses are hypovascular or lack a signal
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6
Q

Malignant

A 
Can invade fibrous plane 
Finger-like projections in radial
True shadow persists with pressure
Ill defined 
May indicate invasion
Spiculated
Angular 
Many small lobulations
Thick
Echogenic halo
Taller than wide
Irregular
Vertical 
Markedly hypoechoic
Heterogeneous
Attenuating
Shadowing
Non compressible 
Fixed
Increased peripheral flow (feeding vessel)
Increased internal flow (flow in tumor mosaic)
Clustered microcalcifications
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7
Q

Layers

A

Skin

Subcutaneous fat

Fascial plane

Mammary zone/ Breast parenchyma, glandular tissue

Retromammary fat

Muscle

Ribs

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8
Q

Blood supply

A

Arteries: internal mammary, lateral thoracic, thoracocromial, intercostal

Veins: superficial and deep networks. Axillary intercostal vein, vertebral veins

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9
Q

Glandular tissue is supported by

A

Cooper’s ligaments

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10
Q

Tail of Spence

A

Mammary tissue which may extend into axilla

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11
Q

Montgomery’s Gland

A

Sebaceous glands in areola

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12
Q

Skin thickness

A

2-3 mm

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13
Q

Fat is affected by

A

Age, parity, and obesity

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14
Q

Fatty tissue is ___ Echogenic than parenchyma

A

Less

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15
Q

Gynecomastia

A

Ductal elements enlarge in males.

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16
Q

Ducts

A

< or = 3 mm

Course towards nipple

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17
Q

Lymph nodes

A

Seen near axilla
< 10-15 mm
Kidney bean, echogenic hilum

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18
Q

Rotter’s nodes

A

Interpectoral group

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19
Q

Breast function

A

Fluid transport

Milk secretion via acini cells due to prolactin. Prolactin is suppressed by progesterone which is high during pregnancy and low after placenta is delivered. Baby sucking on nipple makes oxytocin which also raises prolactin.

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20
Q

Patient position

A

Supine/oblique with ipsilateral arm above head.

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21
Q

Fremitus

Study These Flashcards
A

Power Doppler. Presence of flow confirms solid lesions.

22
Q

Hypoplasia

Study These Flashcards
A

Underdeveloped breast

23
Q

Hypertrophy

Study These Flashcards
A

Overdeveloped breast

May cause back pain and skin problems due to bra strap

24
Polythelia
Accessory nipple MC congenital anomaly In milk line (Embryos have breast buds that normally regress) Black people Can be confused with mole. Assoc with renal cyst/duplication/unilateral agenesis
25
Polymastia
Accessory breast May occur with athelia (no nipple) Enlg with puberty, pregnancy, and lactation. Can have breast pathology
26
Cyst
MC breast lesion Usually benign 35-50 yr old female Pain, palp, mobile, compressible, no color flow within Mammo: spherical or oval, low density, smooth margin, halo sign, eggshell with ca++
27
Fibroadenoma
Common solid benign 15-40 yr old, black women May get bigger when pregnant. Hormone influenced Palp, mobile, nontender, may have macrolobulations Well circumscribed, hypo, smooth margins
28
Breast cancer
Affects 1 in 8 females MC is invasive ductal carcinoma Risk: female, fam hx, inc age
29
Fibroadenoma
Common solid benign 15-40 yr old May get bigger when pregnant. Hormone influenced
30
Breast cancer
Affects 1 in 8 females MC is invasive ductal carcinoma Risk: female, fam hx, inc age, prolonged estrogen Hard fixed painless mass, skin changes, nipple inversion
31
Amastia
No Breast tissue and no nipple
32
Amazia
No Breast tissue. Nipple is present.
33
Unilateral early ripening
One breast develops before the other
34
Precocious puberty
Breast develop before age 7
35
Galactocele
``` Milky cyst Due to obstruction of lactiferous ducts With pregnancy or lactation May progress to mastitis or abscess Usually subareolar Resolves ```
36
Sebaceous cyst
Mild to low level echoes. Oily cyst
37
Intracystic papilloma
Soft tissue mass projecting into cyst
38
Abscess
May result from mastitis Affects lactating females Often below nipple Fever, pain, skin red and thick, palp, enlg nodes, purulent discharge, thick coopers lig, irregular, internal echoes, septations Tx antibiotics, drainage
39
Hematoma
Due to trauma | Variable echogenicity
40
Ductal ectasia
Dilation of lactiferous ducts Menopausal women Prolonged nursing ``` Sticky thick discharge Subareolar nodularity Nipple inversion Intermittent pain Dilated tubes coursing towards nipple Usually bilateral ```
41
Cystosarcoma Phylloides
``` Rare, 50 yrs May be huge Benign May turn into Cancer. Similar to Fibroadenoma ```
42
Intraductal papilloma
Growth in duct. Older women. Usually benign. | Asymptomatic, bloody nipple discharge. Palp subareolar mass. Ductal dilatation, soft tissue mass in duct.
43
Lipoma
Encapsulated adipose tissue Middle age and older women > 2 cm usually Compressible. Palp. May blend with breast.
44
Invasive Ductal Carcinoma
MC 70-80% | Ill defined, hetero hypo, tall, attenuating, micro Ca+
45
Infiltrating Lobular Carcinoma
8-15% Lobulated borders, moderate attenuation.
46
Medullary Carcinoma
Rare, younger females. Round/lobulated, irreg margins, may hemorrhage
47
Mucinous Carcinoma/Colloid Carcinoma
Rare, may be bilateral and multiple Round/oval smooth wall hypo
48
Papillary Carcinoma
Rare, older, palp | retroareolar mass, bloody discharge. Small mass, dilated duct
49
Paget's Disease
Eczema skin change of nipple Assoc with underlying breast cancer 90% Rash, bleeding, red areola, crust ulceration, itch, burn, discharge, nipple inversion.
50
Mets from breast
Nodes, liver, lung, bone, brain Lymphadenopathy rounded and loss of fatty hilum.
51
Make breast cancer
Rare 1% Risk: Kline Felters syndrome (extra X chromosome in males), transsexuals, orchitis tumors, liver disease
52
Cyst more common in
Premenopausal females, females on estrogen or estrogen-progesterone hormone replacement therapy.
53
Fat lobules
Hypo fat in area of dense tissue

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