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Flashcards in Breast Powerpoint Deck (46)
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1

Indications

Palpable breast lump
Correlation with mammography or MRI
Fibrocystic changes
Pregnant or lactating patients
Breast augmentation
Axillary lump
Post-surgical or post irradiated breast
Guidance for interventional procedures

2

Main purpose of breast evaluation is the

detection and diagnosis of breast cancer in its early and curable stages

3

Three general categories of breast imaging, two of which involve breast ultrasound

Breast cancer screening (does not generally involve ultrasound)
Diagnostic (consultive; problem solving; workup) breast imaging
Diagnostic and interventional breast procedures

4

Regular clinical breast exams

by a physician every three years until age 40 then yearly

Screening mammography begins at age 40

5

Ultrasound of the breast is

safer and more accurate in young dense breast

6

Ultrasound can differentiate

solid masses from fluid filled cysts

can visualize tissue adjacent to implants or other structures that limit mammography

7

Interventional breast procedures

Cyst aspirations can be performed

to assess the lesion as a complex cyst or mass

8

Interventional breast procedures

Under sonographic guidance

needle guidance in an attempt to aspirate fluid, which would be diagnostic of a complex cyst

used to guide a fine-needle aspiration cytology (FNAC), abscess or seroma drainage and large-core needle biopsy (for tissue diagnosis)

9

Interventional breast procedures

Needle localization

preoperative wire localization and injection of radioactive tracer for sentinel node identification

10

Interventional breast procedures

The key to needle visualization is

to keep the needle as to the transducer face as possible

11

Interventional breast procedures

Main hazard is

piercing of the chest wall

12

Pathology -benign

Cyst

clinical signs- discomfort, palpable lump, mobility

smooth walls, anechoic, posterior enhancement

13

Pathology -benign

Complicated cyst

clinical signs- may be related to inflammation or hemorrhage within a cyst

14

Pathology -benign

Sonographic findings

wall thickening or irregularities, septations, internal echos

15

Solid mass- benign

Fibroadenoma

Most common breast tumor
Primarily in young women
Growth stimulated by estrogen

16

Solid mass- benign

Fibroadenoma
Clinical Findings

Firm, rubbery, freely mobile
Slow growing

17

Solid mass- benign

Fibroadenoma
Sonographic Appearance

Smooth, rounded margins
Low-level homogeneous internal echos
Possible posterior acoustic enhancement
Typically hypoechoic

18

Lipoma- fatty tumor-benign

May grow large before being clinically detected
Usually found in middle-aged/postmenopausal women
Large, soft, poorly demarcated difficult to delineate from surrounding tissue

19

Lipoma- fatty tumor-benign

Sonographic Findings

Typically smooth walls
Hypoechoic similar to breast fat
Posterior acoustic enhancement
Easily compressible

20

Fat Necrosis- benign

Caused by trauma, surgery, radiation treatment, mastitis
Spherical nodule, superficial under layer of calcified necrosis

21

Fat Necrosis- benign

Sonographic Findings

Irregular
Complex low-level echos
May mimic malignant mass
Acoustic shadowing may or may not be present

22

Abscess-benign

Pain
Swelling
Febrile
Enlarged axillary nodes

23

Abscess-benign

Complex
Diffuse increased echogenicity of the breast (if mastitis)
Hyperemia with color and or/ power Doppler

24

Papillomas -benign

arise from lining of breast ducts, retroareolar area most common
Bloody discharge from single duct

25

Papillomas -benign

Sonographic Findings

Tiny papilloma may not be detected
May cause dilatation of a single duct

26

Papillomas -benign

Intracystic papillomas

soft tissue mass growing into lumen of cystic lesion

27

Sebaceous cysts-benign

obstruction of sebaceous gland or hair follicle within dermal layer of skin

28

Sebaceous cysts-benign

Sonographic Findings

Rounded, well defined mass with low to medium level echogenicity
Wall calcification possible

29

Phyllodes- benign/malignant

borderline or transitional form between benign and malignant tumor
Can grow quite large
Develop in women between ages 40-60

30

Phyllodes- benign/malignant

Sonographic Findings

Well-defined, lobulated solid mass with possible internal cystic spaces