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Breast pathologies
diagnostic medical sonography
80
Medical
Undergraduate 1
10/30/2011

Additional Medical Flashcards

 


 

Cards

Term

An inverting or shriveling of the

 breast tissue

Definition

May result from :

  • degeneration of the breast
  • cessation of lactation
  • aging
  • ovarian abiation
Term
amastia
Definition
complete absence of one or both breasts
Term
athelia
Definition
complete absence of the nipple
Term
polymastia
Definition
accessory breast
Term
polythelia
Definition
accessory nipple
Term
polythelia
Definition
most common anomaly
Term
benign lesions
Definition
  • rounded, oval, slight lobulation
  • wider than tall
  • smooth walls, no projections
  • compressible
  • mobile
  • minimal blood flow
  • displaces tissue planes, does not invade
Term
Simple cyst
Definition
  • very common finding
  • can result from an obstructed duct
  • may be single or multiple, vary in size, and can occur in one or both breasts
  • palpable, compressible
  • pain or tenderness before menstruation
Term
refraction
Definition
edge artifact or edge shadowing is due to what?
Term
complex cyst
Definition
  • any cyst that does not display round or oval shape, smooth contours, echo free, and posterior enhancement
  • may display internal echoes or wall changes
  • may be septated or have fluid/fluid level
  • these cysts should be aspirated and sent to cytology, especially in cases of suspected infection or malignancy
Term
sebaceous cyst
Definition
  • arises in the dermal layer of the skin
  • result from obstruction of a sebaceous gland or hair follicle
  • may need to use a stand-off pad
  • could result in abscess formation
  • may have internal echoes due to contents of cyst
Term
galactocele
Definition
  • milk filled cyst
  • appears during or shortly after lactation due to obstruction of a lactiferous duct
  • should display low level echoes
  • may be associated with mastitis or abscess formation
Term

Fibrocystic changes

(FCC)

Definition
  • Normal physiologic process
  • Most common breast abnormality
  • 40-50% of women
  • affects women ages 30-50

 

Term
FCD
Definition
It is felt that what is related to abnormal ovarian funciton?
Term
Clinical symptoms of FCC
Definition
  • cyclic pain or tenderness
  • diffuse or circumscribed areas of firmness
  • focal lumpiness
Term
Sonographic appearance of FCC
Definition
  • macrocysts
  • microcysts
  • cystic clusters
  • ductal prominence
  • course parenchymal pattern
Term
> 2 mm
Definition
macrocysts measure what?
Term
< 2 mm
Definition
microcysts measure?
Term
Fibroadenoma
Definition
  • common, solid, and benign
  • estrogen induced
  • 15-35 yrs
  • can grow during pregnancy, hormonal changes
  • typically <3 cm, but may enlarge
  • may decrease after menopause
Term
fibroadenoma
Definition
Most common breast tumor in women under age 35
Term
fremitus
Definition

technique used with color doppler to better visualize the borders of a solid mass

 

If sonographer turns on color and asks patient to "hum" the color should outline the borders of a solid mass

Term
Papilloma
Definition
  • results from epithelial proliferation within a duct. Ducts are lines with epi cells
  • usually small
  • mostly located behind the nipple or subareolar region
  • clear, serous, or bloody nipple discharge
Term
lipoma
Definition
  • made of adipose tissue
  • compressible, oval shaped, circumscribed
  • may be difficult to distinguish if large amount of fat exists in breast
  • Isoechoic to parenchyma
Term
hemartoma
Definition
  • proliferation of fibrous and fatty tissues
  • fibroadenolipoma
  • encased in connective tissue
  • encased in connective tissue
  • oval, but may be lobulated
  • heterogeneous echo texture
  • compressible with probe pressure
Term
mastitis
Definition
breast imflammation
Term
puerperal mastitis
Definition
  • Bacteria can enter the breast via a cracked nipple or skin wound
Term
acute mastitis
Definition
lactation is the most common cause
Term
clinical signs of mastitis
Definition
  • tender swollen breasts
  • discharge
  • skin thickening or reddening
  • leukocytosis and possible fever
Term
sonographic visualization of mastitis
Definition
  • edematous parenchyma
  • dilated ducts
  • increased echogenicity of fat
  • hypervascularity of affected tissues
Term
nonpuerperal mastitis
Definition
caused by infected cyst or an inverted nipple with abscess or infection
Term
granulomatous mastitis
Definition

caused by a foreign body, TB, parasitis disease

not as commom

Term
trauma
Definition
  • hematomas and skin bruising

 

Term
seroma
Definition

collection of serous fluid and plasma cells that can occur after surgery or trauma

most reabsorb

Term
trauma
Definition
most common cause of implant rupture
Term
gynecomastia
Definition
  • male breast enlargement
  • can be uni or bilateral
  • associated with increased estrogen and decreased testosterone

 

Term
pseudogynecomastia
Definition
can be seen with obese males
Term
IF pt is sick or has been sick
Definition
most common reason for enlarged lymph nodes is what?
Term
lymph nodes
Definition
may be the target o metastasis
Term
lymph nodes
Definition

Important characteristics:

  • presence of echogenic central hilum in normal
  • total absence of internal in the hilum of pathological
  • normal has an oval appearance
  • rounding is abnormal
Term
  • advanced age
  • early menarche: late menopause
  • nulliparity
  • family history
  • personal history of ovarian or endometrial CA
  • estrogen use
  • obesity
Definition
Breast malignancy Risk Factors:
Term
40
Definition
women should begin yearly mammograms at wht age?
Term
Upper outer quadrant
Definition
what quadrant does cancer occu most in?
Term
  • spiculation
  • taller than wide
  • angular shadowing
  • marked hypoechogenicity
  • duct extension
  • tissue invasion or disruption of tissue plane
Definition
What sonographic markers do you look for in cancers?
Term
satellite mass
Definition
When you image another lesion in the same scan area of the primary lesion, the new lesion is called what?
Term
multifocal
Definition
This refers to lesion in same breast quadrant
Term
Multicentric
Definition

This refers to lesions from one breast to another or from UIQ to LOQ of same breast.

Must be in different quadrants

Term
Ductal carcinoma in situ
Definition
Most common non invasive carcinoma
Term
carcinoma in-situ
Definition
women in there 40's-60's are usually diagnosed with this by microcalcifications on mammogram
Term
invasive carcinoma
Definition

most common type of breast cancer

75% of cases

Term

infiltrating ductal carcinoma

IDC

Definition
most frequent type of invasive cancers
Term
Invasive Lobular carcinoma
Definition
Second most common type of invasive cancer
Term
Invasive Lobular Carcinoma
Definition
Clinically not a "true" cancer because of difficult diagnoses
Term
Colloid/Mucinous
Definition

Soft, sticky tumor has cancer cells suspended in mucinous material

Lacks clinical signs of cancers

Only about 2%

Term
Medullary cancer
Definition
  • Mimics fibroadenoma
  • women under 35
  • about 4-9% of cancers
  • benign qualities
Term
papillary cancer
Definition

Indistinguishable from a benign papilloma

Intracycystic and intraductal forms

Term
Phyllodes Tumors
Definition
  • Proliferative fibroadenoma
  • usually benign by grow rapidly
  • 30-50 years old
  • 10% chance of malignanct transformation
Term
Inflammatory Carcinoma
Definition

Rare, occurs when a highly invasive carcinoma invades the lymphatics of the skin

Swelling, thickening, reddening of skin

Peau d' orange

Term
Peau d' orange
Definition
Reddenign of skin, only in inflammatory carcinoma
Term
lymphatics or blood
Definition
Metastatic disease spreads by way of what?
Term
sentinel node
Definition
first lymph node
Term
melanoma
Definition
most common metastatic to the breast is what?
Term
invasive ductal carcinoma
Definition
Most common type of male breast cancer
Term
  • age
  • exposure to radiation
  • cryptorchidism
  • family history
Definition
Risk factors for male breast cancer:
Term
silicone
Definition
made up of material similar to bodily fluids
Term
silicone
Definition
made of synthetic compounds, most common substance on earth
Term
fibrous cabsule around implant
Definition
Body treats implants as foriegn object, so it forms what?
Term
Trauma
Definition


Most common reason for implant rupture

is what?

Term

saline - echo free

silicone - contain low level echoes

Definition
Saline and silicone implants should sonographically appear
Term
Intracapsular rupture
Definition

rupture of the implant with silicone or saline remaining within the fibrous capsule formed by the body

"stepladder sign" correlates with "linguine sign" of MRI

Term
Extracapsular silicone rupture
Definition

Saline just leaks into the surrounding areas

 

Snowstorm sign - hyperechoic mass effect with loss of posterior wall

Term
MRI
Definition
modality of choice for implant integrity
Term
ductography
Definition

Performed for spontaneous nipple discharge

 

Needle with syringe & contrast material is inserted into leaking duct

Term
Sentinel node procedure
Definition

Radioactive or "blue" dye is inserted and is watched to see the drainage of lymph, it identifies the sentinel node and removed

 

Term
cyst aspiration
Definition
Needle is inserted into complex cyst, atypical cyst or large cyst for patient relief
Term
Pneumocystogram
Definition
Injection of air into area and mammogram images are taken for visualization of cyst wall
Term

Fine needle aspiration

FNA

Definition

thin needle inserted into mass

Quick, short, ecisions are taken from multiple sites in the lesion

Term
excisional
Definition
removes entire lesions
Term
incisional
Definition
removes only a portion of the lesion
Term
Core biopsy
Definition
large needle with hollow core inserted at tumor site and samples of tissue are extracted
Term
mammotome
Definition
vacuum activated, rotating cutting device removes tissue sample which is sucked through the probe into a tissue collection area
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