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ABD class 2 > Breast Powerpoint > Flashcards

Breast Powerpoint Flashcards

1
Q

Indications

A 
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
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2
Q

Main purpose of breast evaluation is the

A

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

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3
Q

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

A

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

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4
Q

Regular clinical breast exams

A

by a physician every three years until age 40 then yearly

Screening mammography begins at age 40

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5
Q

Ultrasound of the breast is

A

safer and more accurate in young dense breast

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6
Q

Ultrasound can differentiate

A

solid masses from fluid filled cysts

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

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7
Q

Interventional breast procedures

Cyst aspirations can be performed

A

to assess the lesion as a complex cyst or mass

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8
Q

Interventional breast procedures

Under sonographic guidance

A

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)

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9
Q

Interventional breast procedures

Needle localization

A

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

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10
Q

Interventional breast procedures

The key to needle visualization is

A

to keep the needle as to the transducer face as possible

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11
Q

Interventional breast procedures

Main hazard is

A

piercing of the chest wall

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12
Q

Pathology -benign

Cyst

A

clinical signs- discomfort, palpable lump, mobility

smooth walls, anechoic, posterior enhancement

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13
Q

Pathology -benign

Complicated cyst

A

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

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14
Q

Pathology -benign

Sonographic findings

A

wall thickening or irregularities, septations, internal echos

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15
Q

Solid mass- benign

Fibroadenoma

A

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

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16
Q

Solid mass- benign

Fibroadenoma
Clinical Findings

A

Firm, rubbery, freely mobile

Slow growing

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17
Q

Solid mass- benign

Fibroadenoma
Sonographic Appearance

A

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

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18
Q

Lipoma- fatty tumor-benign

A

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

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19
Q

Lipoma- fatty tumor-benign

Sonographic Findings

A

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

20
Q

Fat Necrosis- benign

A

Caused by trauma, surgery, radiation treatment, mastitis

Spherical nodule, superficial under layer of calcified necrosis

21
Q

Fat Necrosis- benign

Sonographic Findings

A

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

22
Q

Abscess-benign

A

Pain
Swelling
Febrile
Enlarged axillary nodes

23
Q

Abscess-benign

A

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

24
Q

Papillomas -benign

A

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

25
Q

Papillomas -benign

Sonographic Findings

A

Tiny papilloma may not be detected

May cause dilatation of a single duct

26
Q

Papillomas -benign

Intracystic papillomas

A

soft tissue mass growing into lumen of cystic lesion

27
Q

Sebaceous cysts-benign

A

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

28
Q

Sebaceous cysts-benign

Sonographic Findings

A

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

29
Q

Phyllodes- benign/malignant

A

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

30
Q

Phyllodes- benign/malignant

Sonographic Findings

A

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

31
Q

Solid mass - malignant

A 
Ductal non-invasive carcinoma  in-situ (DCIS)
Lobular carcinoma-in situ (LCIS)
Invasive ductal carcinoma in-situ (IDC)
Invasive lobular carcinoma (ILC)
Medullary
Colloid /Mucinous
Papillary
32
Q

Ductal carcinoma in-situ

A

most common non-invasive carcinoma

Asymptomatic, palpable mass, nipple discharge

33
Q

Ductal carcinoma in-situ

Mammography findings

A

microcalcifications

34
Q

Ductal carcinoma in-situ

Sonographic findings

A

intraductal mass
microcalcifications
irregular ductal dilatation
architectural distortion

35
Q

Lobular carcinoma in-situ (LCIS)

A

generally affects premenopausal women

distinct tumor not a feature

36
Q

Lobular carcinoma in-situ (LCIS)

Sonographic Appearance

A

bilateral, multicentric

mimics fibrocystic disease

37
Q

Invasive ductal carcinoma-IDC

A

Most common malignancy
Hard fixed mass
Skin dimpling or skin/nipple retraction

38
Q

Invasive ductal carcinoma-IDC

Mammography findings

A

Asymmetric
Radiopaque speculated mass
Microcalcifications
Thickened and retracted Cooper’s ligament

39
Q

Invasive ductal carcinoma-IDC

Sonographic findings

A 
Solid mass
Hypoechoic
Heterogeneous
Taller than wide orientation
Distal acoustic shadowing
Possible- microlobulations, microcalcification, ductal extension branch pattern, fascial plane disruption
40
Q

Invasive lobular carcinoma-(ILC)

A

Mammography can underestimate the extent

41
Q

Invasive lobular carcinoma-(ILC)

Sonographic Findings

A

Possible speculated mass mimicking invasive ductal carcinoma

Architectural distortion

42
Q

Medullary

A 
Circumscribed, non-tender, often large palpable mass
May be mildly compressible and movable
Often located in peripheral breast
Low incidence of lymph node involvement 
Prevalence in younger females
43
Q

Medullary

Sonographic findings

A

Solid hypoechoic mass; round, oval, or lobulated shape
Circumscribed margins; surface irregularities possible
Homogeneous/mildly heterogeneous
Acoustic enhancement
Hemorrhage or cystic degeneration may be noted

44
Q

Colloid/Mucinous

Sonographic Findings

A

Well-defined margins
Hypoechoic or isoechoic to fat
Homogeneous
Possible microlobulations

45
Q

Papillary

A 
Subareolar palpable mass
May protrude and effect skin
May cause skin dimpling and retraction
Possible bloody nipple discharge
Mimics  non-invasive papillary carcinoma or papilloma
46
Q

Breast implants

A

Can be challenging to scan

Can be even more challenging to biopsy

ABD class 2 (19 decks)

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