Chapter 21 The breast Flashcards
(107 cards)
1
Q
Glandular (milk-producing) component of the breast lobule
A
Acinus (acini)
2
Q
The pigmented skin surrounding the breast nipple
A
Areola
3
Q
Armpit
A
Axilla
4
Q
Differentiated apocrine sweat gland with a functional purpose of secreting milk during lactation
A
Breast
5
Q
Connective tissue septa that connect perpendicularly to the breast lobules and extend out to the skin
A
Cooper’s ligaments
6
Q
Middle layer of the breast tissue that contains the ductal, glandular, and stromal portion of the breast
A
Mammary layer
7
Q
Deepest of the three layers of the breast noted on breast ultrasound
A
Retromammary layer
8
Q
Most superficial of the three layers of the breast identified on breast ultrasound
A
Subcutaneous layer
9
Q
Normal extension of the breast tissue into the axillary region
A
Tail of Spence
10
Q
Smallest functional portion of the breast involving the terminal duct and its associated lobule containing at least one acinus
A
Terminal ductal lobular unit (TDLU)
11
Q
Plane of imaging on ultrasound of the breast that is perpendicular to the radial plane of imaging
A
Antiradial
12
Q
Without symptoms
A
Asymptomatic
13
Q
Trademark system created by the American College of Radiology (ACR) to standardize mammographic reporting terminology, categorize breast abnormalities according to the level of suspicion for malignancy, and facilitate outcome monitoring
A
Breast imaging reporting and data system
14
Q
Part of breast cancer screening best done at the end of menses each month
A
Breast self examination
15
Q
Part of breast cancer screening done by a health care provider
A
Clinical breast examination
16
Q
Type of breast imaging examination that is more extensive than routine screening mammography
A
Diagnostic breast imaging
17
Q
Refers to vibrations produced by phonation and felt through the chest wall during palpation
A
Fremitus
18
Q
Near the chest wall
A
Juxtathoracic
19
Q
Echo texture that is more echogenic than the surrounding tissue
A
Hyperechoic
20
Q
Can be felt on clinical examination
A
Palpable
21
Q
Echo texture that resembles the surrounding tissue
A
Isoechoic
22
Q
Plane of imaging on ultrasound of the breast
A
Radial
23
Q
Represents the first lymph node along the axillary node chain
A
Sentinel node
24
Q
Finger like extension of a malignant tumor
A
Spiculation
25
Cannot be felt on clinical examination
Nonpalpable
26
Without echoes
Anechoic
27
Having relatively weak echoes
Hypoechoic
28
Common diagnostic and interventional procedure that involves placing a needle through the skin of the breast into a cystic mass and pulling fluid out of the cyst through the needle
Cyst aspiration
29
Preventive care that includes annual screening mammography, (starting at age 40), monthly self-examination, and regular clinical breast examination
Breast cancer screening
30
Overgrowth of the stromal and epithelial elements of the acini within terminal ductal lobular unit (TDLU) of the breast
Adenosis
31
Form of fibrocystic change in which the epithelial cells at the acini undergo alteration
Apocrine metaplasia
32
The pathologist recognizes some, but not all features of ductal carcinoma in situ
Atypical ductal hyperplasia
33
Abnormal proliferation of cells with atypical features involving the TDLU, with an increased likelihood of evolving into breast cancer
Atypical hyperplasia
34
Shows some, but not all, of the features of lobular carcinoma in situ
Atypical lobular hyperplasia
35
Fluid-filled sac of variable size
Cyst
36
Proliferation (hyperplasia) of epithelial cells lining the terminal duct-lobular unit
Epithelial hyperplasia
37
Most common benign solid tumor of the breast, consisting primarily of fibrous and epithelial tissue elements
Fibroadenoma
38
Condition that represents different, essentially normal, tissue processes within the breast that in some patients become exaggerated to the point of raising concern for breast cancer
Fibrocystic condition
39
Surface erosion of the nipple characterized by redness with flaking and crusting caused by direct invasion of the skin of the nipple by underlying breast cancer
Paget's disease
40
Descriptive term for skin thickening of a breast that resembles the skin of an orange
Peau d'orange
41
Cancer of the ductal epithelium; most common general category of breast cancer, accounting for approximately 85% of all breast cancers
Infiltrating ductal carcinoma
42
Cancer of the lobular epithelium of the breast, arises at the level of the TDLU
Infiltrating lobular carcinoma
43
Echo texture that resembles the surrounding tissue
Isoechoic
44
Neither considered a true cancer nor treated as such
Lobular carcinoma in situ
45
Term preferred by many authors to replace LCIS and atypical hyperplasia
Lobular neoplasia
46
Breast cancer occurring in different quadrants of the breast at least 5cm apart
Multicentric breast cancer
47
Breast cancer occurring in more than one site within the same quadrant of the same ductal system of the breast
Multifocal breast cancer
48
Involves two main types of cells (ductal and lobular)
Breast cancer
49
Hypertrophy of residual ductal element that persist behind the nipple in the male
Gynecomastia
50
The breast is a modified ________ gland located in the superficial fascia of the anterior chest wall
Sweat
51
Sonographically the breast is divided into three layers located between the skin and the pectoralis major muscle on the anterior chest wall. These layers are the ___________ layer, the ____________ layer, and the ___________ layer
Subcutaneous, mammary, and retromammary
52
Fat is the least ___________ tissue within the breast
Echogenic
53
The fatty tissue appears _____________, whereas the ducts, glands, and supporting ligaments appear echogenic
Hypoechoic
54
The ______________ quadrants of the breast contains the highest concentration of lobes
Upper outer
55
Each lobule contains __________ (milk-producing glands) that are clustered on the terminal ends of the ducts like grapes on a vine
Acini
56
The ____________ muscle lies posterior to the retromammary layer
Pectoralis major
57
The ______________ tissue can situate itself in and among the areas of glandular tissue, and in some scanning planes it can mimic isoechoic or hypoechoic masses
Adipose or fatty
58
Sonographically, cancers can be difficult to differentiate in the fatty breast because most cancers appear __________ and can be difficult to differentiate from the normal breast tissue
Hypoechoic
59
The main arterial supply to the breast comes from the internal ____________ and the lateral __________ artery
Mammary, thoracic
60
Lymphatic drainage from all parts of the breast generally flows to the __________ lymph nodes
Axillary
61
The primary function of the breast is _________ transport
Fluid
62
The ___________ system is critical in the transport of fluids within the breast
Ductal
63
An important function during the reproductive years is for the breast to make ___________from nutrients and water taken from the bloodstream
Milk
64
Milk is produced within the ___________ and carried to the nipple by the ducts
Acini
65
Breast development begins before _____________ and continues until the patient is approximately 16 years old
Menarche
66
During this time of development, the ductal system proliferates under the influence of
Estrogen
67
During pregnancy, acinar development is accelerated to enable milk production by estrogen, _________, and prolactin
Progesterone
68
The hormone produced by the pituitary gland that stimulates the acini to produce and excrete milk is called _____________
Prolactin
69
The expulsion of the placenta after the birth of a baby causes a drop in circulating progesterone, initiating _____________ production within the breasts
Milk
70
The physical stimulation of suckling by the baby initiates the release of ____________ (produced by the hypothalamus and release by the pituitary gland), which further incites prolactin secretion, stimulating additional milk production
Oxytocin
71
Full maturation of the acini occurs during lactation and thought to be mildly protective against the development of breast __________
Cancer
72
Ultrasound may be used for screening purposes in ____________ breast that are __________ and difficult to penetrate by mammography, to evaluate palpable masses that are not visible on a mammogram, and to image the deep juxtathoracic tissue not normally visible by mammography
Young, dense
73
Ultrasound is also useful in ___________ structures within uniformly dense breast tissue where mammography is limited (e.g.. in differentiating solid, round massed from fluid-filled cysts and visualizing tissue adjacent to implants or other structures that limit visualization by mammography
Differentiating
74
A(n) ____________ aspiration can be performed to determine whether a lesion is a complex cyst or truly a solid mass
Cyst
75
What basic clinical information must the sonographer have for any patient referred for breast ultrasound
Patients age
Risk factors for breast cancer
Symptoms
Location and clinical impression of breast lumps
76
Pertinent clinical information that should be provided by the referring physician includes size and location of the lump, when it was noticed, and its relation to the ___________
Menstrual cycle
77
A dominant cyst is frequently ____________ or ____________ (long axis toward nipple), smooth, soft (some cysts under tension can be firm and are usually very tender), and easily movable
Round or oval
78
Fibroadenomas are usually similar in shape, but they are often quite firm and rubbery in consistency and ________________ on ultrasound
Homogeneously solid
79
Breast cancer is usually lobular or __________ in shape, uneven in surfave contour (sometimes gritty in texture), and fixed or poorly movable
Irregular
80
Most breast masses that arise during the adolescent years are _____________
Fibroadenomas
81
A(n) ______________ implant rupture occurs when there is a breach of the membrane surrounding an implant, but the silicone that leaks out is still confined within the fibrous scar tissue that forms a "capsule" around the implant
Intracapsular
82
As the implant collapses and the membrane folds inward, a series of discontinuous echogenic lines parallel to the face of the transducer may be seen and are referred to as the "stepladder sign" or "__________ sign"
Linguine
83
The use of the ______________ positions is unique to the breast and can often pick up subtle abnormalities extending toward the nipple along the ductal system from the mass
Radial/ Antiradial
84
____________ tend to grow within the ducts and will often follow the ductal system in a radial plane toward the convergence at the nipple
Malignancies
85
To be considered a simple cyst, a lesion must meet which three criteria on ultrasound?
Devoid of internal echoes
Smooth inner margins with capsule
Posterior acoustic enhancement
86
A round or oval shape is usually associated with ____________ lesions, whereas sharp, angular margins are associated with ________ lesions
Benign, malignant
87
The normal tissue planes of the breast are __________ oriented
Horizontally
88
Benign lesions tend to grow within the normal tissue planes, and their long axis lies __________ to the chest wall
Parallel
89
Malignant lesions are able to grow through the connective tissue and may have a ____________ orientation when imaging the breast from anterior to posterior
Vertical
90
If a mass measures longer in the anteroposterior dimension (__________) than in either transverse or sagittal planes (_________), the mass has a vertical orientation that is usually described as being "taller than wide" and is suspicious for malignancy
Height, width
91
Malignant masses will often demonstrate increased _____________ within the lesion and often have a feeder vessel, which can be identified with careful evaluation
Vascularity
92
Lesion more common in younger women are ___________ disease and fibroadenomas
Fibrocystic
93
Older or postmenopausal women are more likely to have _____________ papillomas, duct ectasia, and cancer
Intraductal
94
Skin dimpling or ulceration and nipple retraction nearly always result from
Cancer
95
Benign tumors are rubbery, ___________, and well delineated (as seen in a fibroadenoma), whereas malignant tumors are often stone hard and irregular with a gritty feel
Mobile
96
Clinical signs and symptoms of ___________ include the lumps and pain that the patient feels that fluctuate with every monthly cycle. In most cases both breasts are equally involved
Fibrocystic condition
97
The growth of a fibroadenoma is stimulated ____________
Estrogen
98
Sonographically, fat necrosis appears as an irregular, complex mass with low-level echoes, may mimic a(n) ______________ lesion, and may appear as fat, but is seperate and different from the rest of the breast parenchyma
Malignant
99
___________ may result from infection, trauma, mechanical obstruction in the breast ducts, or from other conditions. It often occurs during lactation, beginning in the lactiferous ducts and spreading via the lymphatics or blood
Acute mastitis
100
An intraductal papilloma is a small, ___________ tumor that grows within the acini of the breast
Benign
101
In _____________ tissue, most cancer growth occurs along the borders
Fibrotic
102
_____________ and ____________ are frequently used as pathways for new tumor development
Lymphatic and blood vessels
103
If the tumor is _________, it continues to grow in one area, compressing and distorting the surrounding architecture
Encapsulated
104
Most cancer originates in the ___________ ductal lobular units , whereas a smaller percentage originates in the glandular tissue
Terminal
105
________ refers to breast tumors that arise from the epithelium, in the ductal and glandular tissue and usually have tentacles
Carcinoma
106
Breast carcinomas are generally categorized by two factors; where the cancer cells originate (___________ or __________) and whether the cancer is prone to spreading (___________ or ________)
Ductal or Lobular
| Noninvasive or invasive
107
Carcinomas that do not normally spread outside the duct or lobule are called noninvasive, noninfiltrating, or ___________ cancers, whereas cancers that spread into nearby tissue are said to be invasive or infiltrating
In situ
