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-Exam 3 breast review
by Phuong
305
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03/28/2011

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Term
A thins breast for x-ray exposure, reduce motion and prevent tissue overlap is what mammography view?
Definition
Compression view in mammography
Term
The most valuable mammo view which view from axilla to the inframammary fold this include pectoralis muscle and it can estimate mass location of superior or inferior to the nipple with slight variation what is this view?
Definition
Medio-Lateral Oblique (MLO) view
Term
The 2nd most valuable view of mammo views, the x-ray beam is perpendicular to floor and marker placement toward axilla to describes location of a mass either medial or lateral to the nipple what is the view?
Definition
Cranio-Caudal (CC) view
Term
Cranial- Caudal (CC) view is
Definition
Identify location of a mass either medial or lateral to the nipple
Term
Medio-lateral Oblique (MLO) is
Definition
Estimate mass location superior or inferior to the nipple with sligth variation
Term
Compression view is
Definition
Reduce motion, prevent tissue overlap
Term
Lateral view is
Definition
Demonstrates pathology in superior or inferior quadrants
Term
Spot compression is
Definition
Greater compression in one spot
Term
The x-ray parallel with floor and can be performed ML or LM to demonstrates mass in superior or inferior quadrants is what view of mammography?
Definition
Lateral view
Term
This is done with or without magnification, use the smaller compression paddles and get the greater compression in one spot is what mammography view?
Definition
Spot compression view
Term
If the mass is above the nipple is in superior region of breast and below the nipple is inferior region of breast this is _________
Definition
ML view
Term
ML lateral view is not ________________
Definition
knowledge of medial or lateral
Term
Which location if the mass is between nipple to marker?
Definition
Lateral
Term
Which location if the mass is between nipple away from the marker?
Definition
Medial
Term
CC view is not ____
Definition
knowledge of superior and inferior
Term
Where is the marker?
Definition
Always in the axilla
Term
How to determine location of mass correlate to US method?
Definition
Use quadrant or clock method
Term
Which view can indicate above the nipple is superior and below the nipple is inferior?
Definition
MLO and ML views
Term
Which view is done at an angle the position?
Definition
MLO view
Term
What is MULD?
Definition
Medial up lateral down
Term
After determine what medial lateral say superior or inferior position what next rule should be used?
Definition
MULD= Medial up Lateral down
Term
Benign is
Definition
Orientation of horizontal
Term
Malignant is
Definition
Orientation of Vertical
Term
What is horizontal orientation?
Definition

Wider than tall

Long axis of tumor parallel to chest wall

Tumors tend to grow within or along the tissue plane

Term
What is the vertical orientation?
Definition

Taller than wide

Long axis of  tumor is perpendicular to chest wall

Demonstrates invasion into other tissue planes

Term
Tumors invade into other tissue planes is
Definition
Malignant
Term
Tumors grow within or along the tissue planes is
Definition
Benign
Term
Complex cysts contain
Definition
Internal echoes or changes in the cystic wall
Term
 The cyst describes as blood cells is
Definition
Hemorrhagic  cyst
Term
The cyst describe as milk is
Definition
Galactocele
Term

The cyst describes as sebum (greasy substance) is

 

Definition
Sebaceous cyst
Term
Nipple discharge from 1 ducts  usually cause by
Definition
Tumor
Term
The 2nd leading cause of CA death in female is_
Definition
Breast cancer
Term
Breast cancer is located most in quadrant of___
Definition
UOQ (upper outer quadrant)
Term
If women have these will get 80% chance of getting breast cancer by age 70  What is it?
Definition
BRCA1 and BRCA2 multations
Term
A person with BRCA1 and BRCA2 multations, usually ____
Definition
Get breast cancer at earlier age than the one without,
Term
2 forms of DCIS are
Definition
Comedo and Non-comedo
Term
The form of DCIS which is low grade and slowing growing what is this form?
Definition
Non-comedo
Term
The form of DCIS which is high grade and aggressive what is this form?
Definition
Comedo
Term
Non-invasive Ductal carcinoma in Situ use which image technique is the best to detect?
Definition
Mammography
Term
What is the other name of phyllodes tumor?
Definition
Cystosarcoma
Term
To follow MD's initial reading is__
Definition
CAD (computer aid diagnosis)
Term
Most accurate for detecting implant rupture, good for staging cancer is___
Definition
MRI
Term

Opposite arm injected with radioactive element and it traces breast cancer is__

 

Definition
Nuclear medicine (scintimamamography)
Term
Dye injected into duct then mammo taken is___
Definition
ductography or galatography
Term
Dye injected around confirmed cancer and flow to lymph nodes- the first node that drains lymphatic fluid is____
Definition
sentinel node
Term
With sentinel node if identify in surgery and BX with cancer free there is__
Definition
good chance no mets to nodes
Term
US guided procedure to confirm presence of cyst or reduce cyst is __
Definition
Cysts apiration
Term
US guided procedure to use 14 gauge needle removed core samples and is not invasive as surgery this is__
Definition
Core biopsy
Term
FNA is not accurate evaluation of what compare to what?
Definition
Cystologic is no as accurate as histologic evaluation
Term
Breast cancer treatment by surgery to remove of breast lump and some surrounding tissue, about 10-20 lymph nodes removed and usually followed by radiation therapy is ___
Definition
Lumpectomy
Term
Breast cancer treatment by surgery to removal of breast, lymph nodes and pectoral fasia and it is the gold standard what is this?
Definition
Modified radical mastecomy
Term
Breast cancer treatment by surgery to removal of breast, lymph nodes pectoralis major and minor muscles disfiguring and outdated, only performed in extreme cases what is this?
Definition
Radical mastectomy
Term
The treatment at local or regional therapy and 6-7 weeks of daily radiation what is this?
Definition
Radiation therapy
Term
The treatment using of anti-cancer drugs given orally or by IV and treat for 6-12 months what is this?
Definition
Chemotherapy
Term
The treatment use drugs as tamoxifen and raloxifene pills or estrogen blocker what is this?
Definition
Hormone therapy
Term
BSE mean
Definition
breast self examination
Term
Screening mammography should be done yearly at ___
Definition
age of 40
Term
What is BIRADS mean
Definition
Breast Imaging Reporting and Data System
Term
This is uncommon cancer and about 1300 new cases dx each year what is this?
Definition
Breast cancer in men
Term
List the types of breast implants?
Definition
single lumen, double lumen, reverse double lumen, expandable implant
Term
What is the single lumen breast implant?
Definition
only silicone or saline
Term
What is the double lumen of breast implant?
Definition
Include inner is silicone and outer is saline
Term
What is the expandable implant ?
Definition
It have seen valve
Term
Stand-off pads is use for breast to
Definition
evaluate superficial structure of the breast susch as superficial tumor or cyst, vessel, duct, lesion, skin thickening, or scanning a surgical specimen
Term
Annotation side of body are
Definition
Right or left breast
Term
Annotation for clock postion (__) or AX ( __) or SA(___)
Definition
Quadrant, Axilla, Subareolar
Term
Annotation scan plane are
Definition
RAD, AR, SAG, TRV
Term
Transverse and sagital planes can be used, in the sagital plane the notch is
Definition
towards the patient head
Term
Transverse and sagital planes can be used, in the transverse plane the notch is
Definition
90 degree towards the sonographer
Term
What is TDLU?
Definition

Terminal ductal lobule unit. the intralobular terminal ducts and extralobular terminal duct made of several lobules

Nearly all breast pathology originate from here

Term
Areola contains what gland?
Definition
Montgomery gland and sebaceous glands
Term
Skin is composed of __
Definition
epidermis and dermis layers
Term
Amazia
Definition
no breast tissue but nipple is present
Term
what is the anomaly of breast if there is the flat or inverted nipple and asymmetric breast growth (unilateral early ripening)
Definition
Amazia
Term
Athelia
Definition
absent nipple
Term
Amastia
Definition
Absent breast (1 or both)
Term
The most common breast anomaly is__
Definition
Polythelia
Term
Polythelia is most common in___
Definition
Men
Term
Polythelia is
Definition
Accessary nipple
Term
Polymastia is
Definition
Accessory or supernumerary breast (have more than 2 breasts)
Term
Where is the mammary milk line?
Definition
Extends from the axilla to the symphysis pubis
Term
Which anomaly is usually along the milk line?
Definition
Polymastia and polythelia
Term
Gynecomatia is
Definition
Enlargement of breast tissue, possible palpable subareolar nodule, breast tenderness, skin thickening and possible nipple discharge
Term
Causes of gynecomatia are
Definition
Hormonal changes; estrogen treatment of prostate cancer; testicular failure; tumor of testicle, adrenal and lung; chronic disease of liver, kidney and lung or by medications; Klinefelters syndrome; idiopathic
Term
Malignant of breast cancer between men and women are
Definition
100x more in women than in men
Term
Breast cancer increase with age is _____
Definition
the most significant risk factor
Term
Family history of breast cancer is ___
Definition
The second strongest risk factor
Term
The higher risk if blood relative had breast CA (either mother or father's side) is
Definition
Familiy history
Term
In family history if 1st degree relative the risk is ___ if 2 relative will have___
Definition
Double-5 time risk
Term
In family history if 2st degree relative the risk is ___
Definition
Risk less clear
Term
BRCA1 and BRCA2 gene mutations are
Definition
Genetic risk factors
Term
A person with gene BRCA1 and BRCA2 will also be increased risk of___
Definition
Ovarian cancer
Term
With personal history of breast cancer if woman with cancer in 1 breast will has____of new cancer in either breast
Definition
3-4 times increased risk
Term
What risk of breast cancer to woman who start menstruating at early age (before 12) or went through menopause late (after 50)
Definition
slightly higher
Term
No children or had first child after 30 is
Definition
 high risk of breast cancer
Term
Risk factor of oral contraceptives and prolonged use of HRT are
Definition
Increase risk of breast cancer
Term
What are the Non- invasive breast cancer?
Definition

Ductal carcinomas in Situ (DCIS)

and

Lobular carcinomas in Situ (LCIS)

Term
MRI or Nuc Med is best for
Definition
LCIS
Term
This is slow growing and non aggressive; occur in elderly women 50-70 years what is it?
Definition
Colloid (mucinous) carcinoma
Term
Colloid (mucinous) carcinoma account in how much of all breast cancer mucinous tumors of mucous producing cells (gelatinous/syrup like)?
Definition
2-3%
Term
US guided procedure to do quick movements to knock loose cells and aspirate them , this is less invasive, minimal complication, result in 1-2 hrs but cytologic is not accurate as histologic evaluation this is__
Definition
Fine needle Aspiration
Term
Core biopsy is
Definition
give hitologic evaluation and get result in 2-3 days this is
Term
FNA is __
Definition
less invasive, minimal complication results in 1-2 hrs
Term
Breast self examination
Definition
Should be performed monthly by women of all ages
Term
Clinical breast examination is
Definition
Performed by a physician, done once every 3 years from age 20-40 and yearly at age of 40
Term
baseline study for women from 35-40 years
Definition
screening mammography yearly
Term
All structures are compared to _____
Definition
mid level echogenicity of fat
Term
Galactocele is
Definition
The cyst associated with childbirth and usually in subareolar region
Term
Other name of sebaceous cysts?
Definition
Epidermal inclusion cysts
Term
This affects 60-90% of women in age of 20-40 cause cyclic pain with multiple nodules probably in bilateral is description of-___
Definition
Fibrocystic changes
Term
Fibroadenoma occur higher in___
Definition

Afican American females

Age 20-40

Term
A NON-neoplastic enlargement of male breast is
Definition
Gynecomastia
Term
What is the prevalent of brease cancer?
Definition
1 out  of 8 female will develop
Term
Breast cancer is the most common ____in female?
Definition
Cancer
Term
Where is the most (90%) originate of breast cancer?
Definition
In the duct
Term
Breast cancer 90% originate in the duct and most arise from :
Definition
TDLU
Term
Breast cancers result in BRCA1 and BRCA2 mutations are___
Definition
10%
Term
The most common of Non-invasive breast cancer is__
Definition
Non-invasive Ductal carcinoma in Situ (DCIS)
Term
Why MRI or Nuc Med best for LCIS?
Definition
Usually this is not associated with microcalcification
Term
The most common breast cancer accounting to ___of cases
Definition
70%
Term
What is the 2nd most common type of invasive breast cancer account 8-15%
Definition
ILC
Term
Warm, red, swollen, hard and painful breast is referred as__
Definition
Hot red breast
Term
Orange peel appearance of skin like edema or thick is referred as__
Definition
Peau d' orange sign
Term
List other modalities for breast are___
Definition

Mammography

CAD

MRI

Nuclear medicine

Ductography

Sentinel node

Term
This is developed by ACR and standardizes reporting and data what is this?
Definition
BIRADS
Term
List the list increased rosl pf breast cancer in males?
Definition

Klinefelter's syndrome

male to female transsexual

History of chest wall irradiation (esp Hodgkin's lymphoma)

History of orchitis or testicular tumor

Liver disease

Genetic predisposition of BRCA2 gene mutation, history of breast ca in female relatives and P53 mutation

Term
Description of males breast are__
Definition

Nipple and areola relatively small,

retains some ductal elements beneath nipple,

doesn't develop milk, producing lobular and acinar tissue and ductal elements usually remain small

Term
This is hypertrophy of ductal elements due to hormonal fluctuations disease processes or medication what is this?
Definition
 Gynecomastia
Term
This rupture of both shell and fibrous capsule and escape of silicone into breast tissue, the silicone can spread through lymph nodes to distant sites what is the rupture type?
Definition
Silicone extracapsular rupture
Term
This rupture accounts for 80% of ruptures, the implant shell rupture and silicone escapes into fibrous capsule what is the rupture type?
Definition
Silicone intracapsular rupture
Term
This is can be imaged with mammo but with lighter compression and MRI most accurate for detecting this rupture, so what is this?
Definition
Breast augmentation (implant)
Term
This rupture is easily absorbed by body and usually diagnosed clinically due to rapid deflation what is this?
Definition
Saline implant rupture
Term
Breast augmentation (implantation) appx ____women have had.
Definition
2-3 million women
Term
Breast implants filled with _______
Definition
saline, silicone gel or combination of saline/silicone
Term
This is found throughout the breast what is this?
Definition
 Intramamary lymph nodes
Term
In lymphatic system this appx 75% of lymph drainage goes to__
Definition
Axilla
Term
This system is begins deep in breast toward areola, then eventually outward to chains that drain the breast what is this system?
Definition
Lymphatic system
Term
Vascular supply to breast include arterial and venous, what are two main arteries in arterial system?
Definition
Lateral thoracic artery and internal mammary artery
Term
Vascular supply to breast include arterial and venous, what are the other arteries in arterial system?
Definition
Thoracoacromial artery and intercostal artery
Term
Vascular supply to breast include arterial and venous, what are the venous system include?
Definition
Superficial and deep systems
Term
How is the normal sonographic appearance of  lymph node?
Definition
Hypoechoic cortex with hyperechoic hilum and oval shaped
Term
How is the normal sonographic appearance of  ribs?
Definition
hyperechoic with shadowing and found deep to retromammary layer
Term
How is the normal sonographic appearance of  pectoralis muscles layers?
Definition
hypoechoic with hyperechoic striations and found in deep to retromammary layer
Term
How is the normal sonographic appearance of Dense fibroglandular tissue?
Definition
Hyperechoic, it is combination of glandular epithelium and loose and dense connective tissues in parenchymal layer
Term
How is the normal sonographic appearance of Lactiferous ducts?
Definition

Hypoechoic, if dilated and fluid filled may appear as anechoic

this can distinguish from vessels by using Dopplers

Term
How is the normal sonographic appearance of within mammary layer include:
Definition

Glandular epithelium (isoechoic to mildly hypoechoic)

Dense fibroglandular tissue (hyperechoic)

Lactiferous ducts (hypoechoic)

Term
How is the normal sonographic appearance of skin layers?
Definition
Hyperechoic and thick about 0.5-2mm thick
Term
How is the normal sonographic appearance of fat?
Definition
Medium gray, this is found in superficial, parenchymal, retromammary layers
Term
What is the parenchymal in young females?
Definition
dense, fibroglandular , hyperechoic
Term
What is the parenchymal in lactating females?
Definition
Hyperechoic
Term
What is the parenchymal in aging progresses females?
Definition
the tissue become fatty (isoechoic)
Term
This is create distance between the face of the probe and the skin surface to improve focusing and greater detail what is this?
Definition
Stand-off pads
Term
Stand-off pads can be a _________ and ideal thickness for breast imaging is__________-
Definition
commercial gel pad, or a watere bag or even a large glob of gel - 1cm
Term
To evaluate specific area on breast only is
Definition
target exam
Term
To survey entire breast with attention to certain area is
Definition
Whole breast exam
Term
What is disadvantage of of sonography in breast exam?
Definition
Not helpful as screening tool for breast cancer and cannot detect microcalcification
Term
What is patient position for breast exam?
Definition
Pt lies supine with ipsilateral arm placed behind head and may need to place some towels/ sheets under the pt's shoulder
Term
What transducer for breast exam?
Definition
High frequency transducer (12-15 MHz) used with moderate pressure
Term
What method is distance from the nipple?
Definition
123 method
Term
What method is depth of lesion?
Definition
ABC method
Term
What is 123 mean
Definition

1 near nipple

2 mid distance from nipple

3 periphery of breast

Term
What is ABC mean?
Definition

 A superficial

B mid depth (likely within mammary layer)

C near chest wall

Term
Anti-radial is
Definition
90 degrees from the radial position
Term
Anti radial the notch is __
Definition
Up or Toward sonographer
Term
List in order the anatomic layers
Definition

Skin

Subcuataneous layer (premammary)

Mammary layer

Retromammary space

Muscle layers (pectoralis major and minor)

Chest wall (ribs and intercostal muscles)

Term
The layer of superficial fascia deep within retromammary space posterior to mammary layer, and important to deter spread of cancer to chest wall is
Definition
Deep fascia
Term
Space between the posterior margin of mammary layer and pectoral muscles is
Definition
Retromammary layer
Term
The retromammary layer contains__
Definition
thin layer of fat, deep layer of superficial fascia, and the amount of fat will increase with age, pregnancy and obesity, the deep layer of superficial fascia allows movement of breast of chest wall.
Term
What is lactiferous ducts?
Definition
Intralobular terminal duct and extralobular terminal duct transports milk to nipple
Term
What is lobe?
Definition
several lobules (or TDLU's)make up breast lobe, each breast contains 15-20 lobe, and 1 latiferious duct emerges from each lobe and travels toward nipple
Term
All breast pathology originate from where in breast?
Definition
TDLU
Term
How many lobes in each breast?
Definition
15-20 lobes
Term
how many lactiferious duct in each breast?
Definition
1
Term
How many acini made up of lobule?
Definition
approx 30
Term
What is the lobule?
Definition
Composed of about 30 acini
Term
What is the acini?
Definition
 The smallest functional unit of the breast
Term
What is other name of mammary layer?
Definition
Parenchymal/ or glandular
Term
There is 2 tissue types of mammary layer are:_
Definition
Stroma and Epithelium
Term
What is stroma?
Definition
Supportive tissue of breast
Term
What is a part of stroma?
Definition
Cooper's ligaments
Term
What is cooper's ligaments?
Definition
Part of stroma and supportive tissue run between the superficial and deep layers of the superficial fascia
Term
What is epithelium?
Definition
Functional tissue
Term
Epithelium include in
Definition
acini, lobules, TDLU's, lobes and lactiferous ducts
Term
where is the mammary layer locate?
Definition
axillary tail of spence extends to axilla
Term
This is breast tissue and is completely contained between the layers of this layer and this layer splits into the superficial layer and deep layer is called
Definition
Superficial fascia
Term
The most superficial consists primarily of fat and also contains cooper's ligaments and located immediately beneath skin (thin) is called__
Definition
Subcutaneous (premammary layer)
Term
This is circular area of darker pigmentation seen around nipple and contains Montgomery glands is called as
Definition
Areola
Term
Sebaceous glands is seen as ___on areola?
Definition
 Bumps
Term
This contains many senory nerve endings and about 15-20 collecting lactiferous duct opening what is this?
Definition
Nipple
Term
Normal thickness of skin is__
Definition
0.5-2mm
Term
What is pores for?
Definition
Sweat glands, sebaceous glands and hair follicles
Term
Skin is thicker in ___and thins in __
Definition
young female , with age
Term
Subcutaneous layer and retromammary layer are thin layer contain:
Definition
fatty tissue and cooper's ligaments
Term
Mammary is __
Definition
Functional portion of the breast
Term
Cooper's ligaments extend from the____
Definition
retromammary fascia to the skin and provide support
Term
Terminal ductal lobular unit (TDLU) is made up of __
Definition
acini and terminal ducts
Term
Fatty tissue interspersed ___
Definition
Between the lobes
Term
Lactifereous ducts carry milk from___
Definition
Acini to the nipple
Term
______________lobes radiate from the nipple
Definition
15-20
Term
Mass shapes include:__
Definition
Round/oval/ lobulated/Irregular (angle and straight line)/Spiculated
Term
Benign mass shapes includes:
Definition
round/oval/lobulated
Term
Malignant mass shapes includes:
Definition
Lobulated/ Irregular (angle and straight lines)/ Spiculated
Term
Mass margin include:_
Definition

Smooth/ tumor displaces adjacent tissues

Macrolobulated/ gentle, larged lobulations

Microlobulated/ small and less than 2mm lobulations

Ill defined/ indistinct margins

Angular/ irregular , jagged

Spiculated/ straight lines radiate from center of tumor

Term
Benign margins include:_
Definition
Smooth/circumscribe and Macrolobulated
Term
Malignant margins include:_
Definition
Microlobulated / Ill defined/ Angular/ Spiculated
Term
Tumor displaces the adjacent tissues in which margin?
Definition
Smooth
Term
Margin is gentle large and lobulations what is this margin?
Definition
Macrolobulated
Term
Margin is small and less than 2 mm lobulation what is this margin?
Definition
Microlobulated
Term
This is irregular and jagged what is this margin?
Definition
Angular
Term
This margin is indistinct margins what is this?
Definition
Ill defined
Term
They are straight lines radiate from the center of the tumor what is this margin?
Definition
Spiculated
Term
List all benign mass in breast?
Definition

Cysts (simple or complex)-Galactocele-Sebaceous cyst-Fibrocystic changes-Fibroadenoma and Juvenile

Fibroadenoma-Intraductal papilloma-Lipoma-Mastitis-Abscess-Trauma (Hematoma/Seroma) - Gynecomastia(Male)

Term
Simple cysts occur in____
Definition
35-50yr
Term
The cyst describes as fat and protein cells is____
Definition
Fatty cyst
Term
The cyst describe as purulent fluid and may have thick walls is _
Definition
Inflammatory cyst
Term
The cyst describe as purulent fluid or possible with thick walls is
Definition
Abscess
Term
By which way to prove benign from CA of fibrocystic changes?
Definition
Biopsy is only way
Term
Intraductal papilloma is
Definition
tumor projecting into the lumen of the duct
Term
This the most common during lactation in the 2nd or 3rd postpartum week, cracked nipple can allow bacterial infection what is it?
Definition
Benign- inflammation mastitis
Term
Abscess in breast is __
Definition
complication from mastitis
Term
Blood filled tumor due to direct trauma and may see skin bruising is
Definition
Hematoma in trauma
Term
Gynecomastia is associated with
Definition

Increase in estrogen and or decrease in testosterone

in Unilateral or bilateral

Term
Causes of nipple discharge are
Definition
Various breast diseases or incidental
Term
What are the invasive breast cancer?
Definition

Invasive Ductal carcinoma (IDC)

Invasive Lobular carcinoma (LDC)

Medullary carcinoma

Colloid carcinoma

Papillary carcinoma

Term
What is the most common type of breast cancer?
Definition
Invasive ca-Invasive ductal carcinoma (IDC)
Term
What is the differentiate with invasive papillary carcinoma?
Definition
Non-invasive papillary cancer and benign intraductal papilloma
Term
What are the other cancer types in breast?
Definition

Paget's disease

Phyllodes tumor

Inflammatory carcinoma

metastasis

Term
US guided procedure to flexible wire placed through needle into breast lesion and hook or barb it in place is__
Definition
Needle localization
Term
where is the implants placed?
Definition

-Subglandular (posterior to parenchymal layer and anterior to pectoralis muscles)

-Subpectoral (posterior to pectoralis muscles)

Term
How is the normal sonographic appearance of cooper's ligaments are__
Definition
Hyperechoic, this is part of dense connective tissue and best seen in superficial fat layer as thin , wavy linear structures and may shadow
Term
What should the sonographer visually inspect breast for?
Definition

Size, shape, contour and symmetry

Skin redness, edema, dimpling or retraction, protrusions and thickening

Nipple retraction or discharge

surgical scars

Term
To obtain patient history what should be needed?
Definition
Age , history of brease disease, history of cancer, family history of breast cancer, medication (hormones) pervious breast surgeries, pain level and location
Term
Indication for breast US are
Definition

Palpable lump

Follow up mammographic abnormality

Mass characterization

Evaluate inflammation, implants, nipples discharge

Male breast

Guide procedures

Term
Describes as round/oval anechoic with smooth margins, sharp borders, contain acoustic enhancement/edge shadowing and compressible with no internal Doppler signal is description of ___________
Definition
Simple cysts
Term
Simple cysts due to ___
Definition
obstructed lactiferous ducts, usually in the TDLU or from hormonal dilatation
Term
The cyst describes as calcium in dependent portion (collection of tiny calculi within the lumen of a cyst) is
Definition
Milk of calcium cyst
Term
What type of cysts US finding as gravity dependent debris, wall thickening, septations, low to medium level echoes?
Definition
Complex cysts
Term
US finding of galactocele is
Definition
Round/oval/lobulated/ and well defined mass with hypoechoic to isoechoic, acoustic enhancement
Term
Sebaceous cyst is obstructed ___
Definition
sebaceous gland in dermis
Term
US finding of sebaceous cyst is
Definition
Round/ well defined in superficial with acoustic enhancement
Term
Fibrocystic changes is
Definition
Cysts of various sizes/ it can be simple or complex, cluster of cysts
Term
What is the most common SOLID, benign tumor of the breast and arise from TDLU?
Definition
Fibroadenoma
Term
Fibroadenoma is
Definition
Painless, palpable, firm or rubbery and moveable
Term
US findig of Fibroadenoma is__
Definition
Round/oval/lobulated well defined borders, with hypo to isoechoic /homogeneous and thin echogenic pseudocapsule with edge shadowing
Term
This may be hypervascular, occur in adolescents and grow rapidly up to 5cm usually surgical removed what is it?
Definition
 Benign-Juvenile (giant) Fibroadenoma
Term
This occur in 30-55 years, tumor projecting into the lumen of the duct, with most common cause of bloody nipple discharge and NON-Palpable and LESS THAN 2cm (<2cm)
Definition
Benign-Intraductal Papilloma
Term
US finding of intraductal papilloma is
Definition

Located in subareolar region (radial scan will help)

Single of multiple, small, SOLID hypo to iso round/oval or TUBULAR lesion in duct, may see dilated ducts and Doppler signal in solid component.

Term
Benign-lipoma is
Definition
Only tumor with a true capsule and contains adipose tissue
Term
This arise from subcutaneus FAT layer  anywhere is body, in breast usually located superficially or can be at retromammary, it is soft, compressible and mobile.  What is it?
Definition
Benign Lipoma
Term
Symptom of inflammation Mastitis is
Definition
Pain, swelling, redness, local skin thickening, purulent nipple discharge, leukocytosis, fever, antibiotic used to resolve
Term
US finding of Inflammation mastitis is _
Definition
Increased echogenicity of superficial fat and parenchymal layers; Possible shadowing due to cellulitis (edema), blurred tissue planes, skin thickening; possible dilated ducts; hypervascular
Term
This is localized area of pus and can form anywhere in the body, if in breast it is usually in Retro-Areolar region
Definition
Abscess
Term
US finding of Abscess is
Definition
Complex, predominatly cystic mass with thick irregular borders and acoustic enhancement, localized skin thickening increase, it is increased Doppler signal at periphery
Term
US finding of trauma in both form of hematoma and seroma are
Definition
Simple cyst, fluid with angular margins, low level internal echoes thick wall with septations
Term
Nipple discharge come from galatorrhea are:
Definition
Bilateral milk discharge from non-lactating- non-pregnant women that is endocrine or medication included
Term
Nipple discharge from purulent is
Definition
usually unilateral and multiple ducts
Term
Benign cause of nipple discharge is in___
Definition
Intraductal papilloma or duct ectasia
Term
Malignant cause of nipple discharge is in___
Definition
Intraductal papillary carcinoma
Term
Which discharge that may indicated of breast cancer?
Definition

Serous (clear yellow)

Serosanguineous (pink-serous and bloody)

Sanguineous (Red bloody)

Watery (clear pale yellow)

Term
List risk factor of breast cancer?
Definition
Gender-Age-Family history-Genetic-Personal history of breast cancer-Mentrual period-Child bearing-Hormonal influence
Term
Non-invasive Ductal carcinoma in Situ (DCIS) is
Definition
The most common  DCIS and the second most common of breast cancer overall
Term
This carcinoma confined within the duct and arise from the TDLU what is it?
Definition
Ductal carcinomas in Situ
Term
US finding of DCIS are
Definition
Mass or no mass with shadowing, architectural distortion and possible duct dilation, best seen with mammo at Microcalcification
Term
Which carcinoma arise from the lobule in premenopausal women usually in bilateral and multi-quadrant?
Definition
LCIS = lobule carcinoma in Situ
Term
LCIS is difficult detected by___
Definition
Mammo or sonography
Term
When the LCIS develop to invasive ca?
Definition
10 fold risk because this associated with invasive ca to opposite side of breast
Term
This is a malignant change of ductal epithelium/invades through the duct what is this carcinoma?
Definition
Invasive ductal carcinoma
Term
The IDC sign and symptoms?
Definition
Patient present with palpable mass, hard "gritty" texture, immovable, skin dimpling or retraction or nipple retraction.
Term
US finding of IDC are
Definition
SOLID mass, irregular, angular or spiculated, taller than wide, markedly hypo heterogeneous, with post shadowing.
Term
This is malignant changes of the lobular epithelium/invasion outside the lobule what is this?
Definition
Invasive lobular carcinoma ILC
Term
ILC account how many percentage?
Definition
8-15%
Term
Invasive lobular carcinoma is __
Definition
Most frequently missed breast cancer because usually non-palpable, this may Mets through lymphatics / bloods
Term
Which carcinoma difficult to detect by mammo or US due to no microcalcification?
Definition

Non-invasive -->Lobular carcinoma in Situ LCIS

Invasive--> Invasive lobular carcinoma ILC

Term
This is occur in young women, fast growing/large but good prognosis account 5% of all invasive breast cancer what is this?
Definition
Medullary carcinoma
Term
Medullary carcinoma account how many percent in all invasive breast cancer?
Definition
5%
Term
The medullary carcinoma is__
Definition
Non tender, compressible, slightly movable and commonly mistaken for benign fibroadenomas
Term
US finding of Medullary carcinomas are___
Definition
Large, SOLID, round/oval or Macrolobulated, taller than wide, irregular borders, possible enhancement
Term
US finding of colloid (mucinous) carcinoma are __
Definition
Hypoechoic to isoechoic in comparison to fat, well circumscribed, homogenous, shadowing uncommon; and complex cystic mass
Term
This is malignant version of intraductal papilloma in posmenopausal women mass locate in subareolar with nipple discharge what is this?
Definition
Papillary carcinoma
Term
US finding of papillary carcinoma?
Definition
Well marginated, SOLID mass, ductal dilation, possible microcalcifications or complex mass
Term
This is RARE, underlying carcinoma (usually in invasive carcinoma or carcinoma in Situ) this spread up within ducts to surface epithelium of nipple what is this?
Definition
Paget's disease
Term
Paget's disease dx clinically as___
Definition

Crushty, scaly, red nipple or areola

Bleeding , oozed, itching or burning of affected area

Term
US finding of paget's disease are__
Definition
Nipple / areola skin thick, possible ductal dilation, possible subareolar mass
Term
This is RARE and occur in women 30-50 years, Solitary, large tumor that can be reoccur what is this?
Definition
Phyllodes tumor
Term
Phyllodes tumor or cystosarcoma is seen as__
Definition

"leaf like", connective tissue (stroma); it usually benign but can be malignant

It is large, palpable, firm mobile mass and may bulge skin

Term
US finding of phyllodes tumor are__
Definition
Large/ SOLID well defined mass with smooth, lobulated borders; hypo or isoechoic; homo or hetero; and possible acoustic enhancement
Term
This is poor prognosis and this is a primary breast cancer (usually IDC) that invades lymphatics vessels of breast what is this?
Definition
Inflammatory carcinoma
Term
Inflammatory carcinoma describe as____
Definition

Warm, red, swollen, hard, painful breast-"hot red breast"

like orange peel appearance of skin as edema/ thick- "Peau d' orange" sign

Term
Inflammatory carcinoma is seen with__
Definition
flattening/retraction of nipple, palpable mass and lymph node enlargement
Term
US finding of inflammatory carcinoma are__
Definition
skin thickening; dilated lymph vessels; tissue plane disruption; diffuse appearance of parenchymal layer and all tissues are hypervascular
Term
This is spread by lymphatic, blood and direct invasion what is this?
Definition
Metastasis
Term
Where are primary breast cancer spread to?
Definition
Lymph nodes, bone, lung, liver and opposite breast
Term
Where is the most common nodal mets?
Definition
Axillary lymph nodes
Term
Distant mets is when____
Definition
It spread to supraclavicular lymph nodes
Term
Where the Metastatic cancer to breast comes from?
Definition
Melanoma (most common), lymphoma, lung, sarcoma, ovary and opposite breast
Term
US findings of metastasis are__
Definition
Multiple well circumscribed palpable masses; hypoechoic; located in superficial fat layer often BILATERAL
Term
This is suspicious and finding are often cancer with irregular solid mass, microcalcifications and consider Bx That is ___
Definition
BIRADS 4
Term
This is malignant because 95% or more with chance of being malignant with spiculated mass, solid mass with nipple retraction or skin thickening requires BX what is this?
Definition
BIRADS 5
Term
This is probably benign and the lesion that have equal or less than 2% chance of being malignant and includes complex cysts, small intraductal papillomas and a a subset of fibroadenomas, need short term follow up or biopsy what is this?
Definition
BIRADS 3
Term
This is normal with normal sono tissues that cause mammographic or clinical abnormalities need follow up what is this?
Definition
BIRADS 1
Term
This is benign includes intramammary lymph nodes, estatic ducts, simple cysts and defintely benign nodules such as lipomas need follow up what is this?
Definition
BIRADS 2
Term
How is the normal sonographic appearance of Glandular epithelium?
Definition
Isoechoic to midly hypoechoic and TDLUs and acini in parenchymal layer
Term
If palpable lump notes so what should be documentation for?
Definition
Location size, shape, consitency, mobility, distance from the nipple and date first discovered and if it has changed over time
Term
The sonographic appearance of breast exam depend on many things as___
Definition
Age, inherited breast tissue pattern, functional state of the breast