Unit 4a & 4b: Breast Pathology & BIRADS Flashcards

1
Q

Irregular is only used to describe ____

A

SHAPE
(not margins)

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2
Q

Parallel means ___ than ___
Non parallel means ____ than ____

A

Wider than tall ( think equal sign)
Taller than wide

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3
Q

What is the most common cause of breast lumps in women 35-50 yrs?

A

CYSTS

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4
Q

What is FCC?

A

Dilatation of ducts within obstructed TDLUs - most common this way - typically go away on their own - thought to be caused by estrogen increase

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5
Q

Key features of FCC include: FOUR

A

1) Epithelial hyperplasia
2) Adenosis ( enlarged lobules)
3) Stomal fibrosis
4) Cyst formation

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6
Q

FCC symptoms include: THREE

A

1) Tenderness/pain/fullness/nodularity
2) Bilateral
3) Nipple discharge

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7
Q

Thin wall, mobile internal echoes/debris, fat fluid level are all signs of a _____ cysts

A

Complicated

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8
Q

Complex cystic and solid mass that are suspicious contain a ____ wall, ____ septations, ______ mass, and mixed solid and cytic componenets

A

thick
thick
intracystic

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9
Q

True or false: malignant cysts are common

A

False

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10
Q

True or False: VAB or vacuum assisted biopsy are most common

A

True - they want to test the debris

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11
Q

How can you differentiate between an acorn cyst and PAM (papillary apocrine metaplasia) ?

A

Acorn cyst fat layer will be non-dependent
PAM has a crescent like layer of echogenicity that is non-mobile - associated with FCC

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12
Q

An abnormal change of growth of cells associated with FCC - non-mobile cresent shape - may not aspirate

A

PAM -papillary apocrine metaplasia

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13
Q

What is the most common BENIGN mass in a lactating patient?

A

Galactocele

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14
Q

Retention cysts develop from the ___ glands due to blockage

A

Montgomery

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15
Q

Mastitis is most common during ___

A

pregnancy and lactation

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16
Q

What is the most common location of an abscess?

A

Subareolar

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17
Q

Acute thrombophlebitis of superficial veins of breast or chest wall affecting men and women (clot in superficial veins) - SUPERFICIAL CORD LIKE MASS

A

Mondor Disease

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18
Q

Fat necrosis is caused by _____ - can show dimpling, inversion and skin thickening

A

trauma

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19
Q

How can you differentiate a scar versus a mass? Think of shadowing

A

Transducer pressure - if you apply pressure and shadow is reduced it is probably a scar!

20
Q

Benign characteristics: FOUR

A

1) Hyperechoic
2) wider than tall
3) Multilobulated ( smoothed and curved)
4) Thin, echogenic capsule

21
Q

Malignant characteristics: SEVEN

A

1) spiculation
2) taller than wide
3) angular margins
4) markedly hypoechoic
5) shadowing
6) calcification
7) duct extensions

22
Q

Low risk nipple discharge : THREE

A

1) bilateral
2) muliple duct orifices
3) milky greenish

23
Q

Increased risk of nipple discharge: FIVE

A

1) Unilateral
2) Spontaneous
3) single duct orificie
4) clear, serous fluid or slight blood
5) associated with skin or nipple changes

24
Q

What is the most common cause of increased risk nipple discharge ?

A

Intraductal Papilloma ( not cancerous)

25
Q

What is the most common benign solid tumour of breast?

A

Fibroadenoma
(estrogen induces, slow growing)

26
Q

Secretory adenomas are common in ____patients and are similar to galactocele

A

Lactating

27
Q

This tumor is leaf shaped, and appears similar to a fibroadenoma, but has thin clefts of mucinous, hemorrhagic or cystic fluid ( cystic spaces!)

A

Phylloides Tumor

28
Q

Also called a “pseudo tumor” and appear isoechoic

A

Hamartoma

29
Q

What is the most common Benign Papillary Lesions?

A

Intraductal (large duct) Papilloma

(little benign polyps in the duct, usually within a major lactiferous duct rather than a TDLU)

30
Q

What is the #1 cause of spontaneous bloody nipple discharge from a single breast duct?

A

Intraductal Papilloma

31
Q

Malignancy of the breast usually develops in the __ __ quadrant and most commonly originates from the ____

A

Upper Outer
Ducts (TDLU)

32
Q

Increased risks of malignancy are:

A

1) age
2) female
3) personal or family hx
4) genetics (BRCA1 and BRCA2 gene mutations)

33
Q

What does TNM staging stand for?

A

Tumor
Nodal Status
Mets

34
Q

Abnormal cells form in the small ducts of the breast lobule and are confined to the boundaries of the duct or lobe is called:

A

Lobular Carcinoma in Situ (LCIS)
** not actually treated as a true cancer)

35
Q

What is the most common non-invasive cancer?

A

Ductal carcinoma in situ (DCIS)

36
Q

What is the earliest form of cancer that can be detected on imaging?

A

DCIS

37
Q

Cancer of the epidermis of the nipple ; redness, ulceration, crusting and discharge of nipple

A

Paget’s Disease

38
Q

What is the most common breast cancer?

A

Invasive Ductal Carcinoma (IDC)

39
Q

Asymmetric, irregular, radiodense mass with spiculated margins is indicative of:

A

Invasive ductal carcinoma

40
Q

The second most common invasive breast cancer is

A

Invasive Lobular Carcinoma (ILC)

41
Q

Well marginated/ circumscribed, young women, rapid growing, central necrosis is common

A

Medullary carcinoma

42
Q

Colloid carcinoma is also called a ___ carcinoma

A

Mucinous

43
Q

Small, slow growing, prominent reactive fibrosis, associated with radial scars

A

Tubular Carcinoma

44
Q

Mets from the breast most commonly go to the _________

A

Axillary Lymph node ( sentinel lobe is a low axillary ln)
bone, liver, lung, brain

45
Q

Mets to the breast most commonly arise from the

A

other breast
Melanoma

46
Q

The most common male breast abnormality is ______ associated with increased estrogen-testosterone ratio

A

Gynecomastia
(Pseudogynecomastia is caused by obesity)

47
Q

Strong associated to _____ syndrome and genetics for male breast cancer

A

Klinefelter