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Breast Ultrasound
Breast Ultrasound Vcab
| Question | Answer |
|---|---|
| acinus (acini) | glandular (milk producing) component of the breast lobule |
| lobule | the breast contains hundreds of lobules, each containing several small glands (acini) |
| adenosis | overgrowth of the acini within the terminal ductal lobular unit (TDLU) of the breast; one component of a fibrocystic condition |
| anechoic | without echos; simple cyst on U/S should be anechoic |
| antiradial plane | plane of U/S breast imaging that is perpendicular to the radial plane |
| radial plane | this imaging uses the nipple as the center point of an imaginary clock face imposed on the breast.12:00 = extends upward toward top of breast; 9:00 extends straight out to right breast; 6:00 straight down; 3:00 extends medially |
| Three dimensional measurements of a breast mass can be recorded using | sagittal/transverse or radial/antiradial |
| apocrine metaplasia | form of fibrocystic change in which the acini epithelial cells undergo alteration; epithelial cells become columnar like a sweat (apocrine) gland. this can lead to cyst formation, hyperplasia, & other changes of fybrocystic condion . |
| areola | pigmented skin around the nipple |
| asymptomatic | without symptoms. only women that are asymptomatic are eligible for a screening mammogram |
| screening mammogram | fast, low-cost mammo exam. only asymptomatic women are eligible. |
| diagnostic mammogram | more extensive mammo exam; used for eval of a specific symptom or abnormal finding |
| atypical ductal hyperplasia (ADH) | abnormal cells w atypical features of the TDLU, increased likelihood of becomning breast CA; in atypical ductal hyperplasia the patho recognizes some, but not all, features of ductal carcinoma insitu (DCIS); atypical lobular hyperplasia shows some but not |
| axilla | armpit; contains lymph nodes that drain the majority of the breast tissue. In invasive breast CA, the lymph nodes are generally sampled to accurately stage & direct further treatment |
| breast | differentiated apocrine sweat gland w a functional purpose of secreting milk/lactating. |
| breast CA | involves 2 main types of cells. ductal & lobular |
| ductal breast CA | accounts for @ 85% of breast CA, includes many subtypes (medulary, mucinous, tubular, apocrine, papillary_. Very early/ preinvasive breast CA is generally ductal. in situ, non-invasive, intraductal breast CA, or ductal carcinoma in situ (DCIS) |
| breast CA screening | screening involves annual screening mammo, starting @ age 40; monthly self-exams (BSE) & regular clinical exams (CBE) |
| breast imaginag reporting and data system (BI-RADS) | trademark system created by the American College of Radiology (ACR) to stadardize mammo reporting terminology, catagorize breast abnormalities and to facilitate outcome monitoring. |
| What is the Mammo Quality Standards Act of 1994 | the federal legislation that made BI-RADS a mandatory part of mammo reports |
| What risk factors are associated with an increased risk of developing breast cancer? | Age, family history of breast cancer, early menarche, late menopause, nulliparity, and a late first full-term pregnancy. |
| After which age does the risk of developing breast cancer steadily increase in women? | 40 |
| If a cancer is present in a woman over age 50, mammography has what chance of detecting it? | 90% |
| Cancer typically has what appearance on mammogram? | It appears as a stellate mass with spiculated margins. |
| What are common signs of breast cancer on mammography? | Clusters of microcalcifications, skin thickening, nipple retraction, venous engorgement, and asymmetry of the breast tissue. |
| Benign fibroadenomas typically have what appearance on mammogram? | Dense popcorn-like calcifications |
| What further workup is needed after a nonpalpable suspicious lesion is seen on mammogram? | The lesion can be localized by the radiologist for biopsy and/or resection with mammographic or ultrasound guidance. |
| The National Cancer Institute estimates what percentage of women over 50 have never had a mammogram? | 40%!! |
| HISTORY: A 36 year old female presents with a palpable mass in her left breast. She first noticed the mass one week ago while taking a shower. The mass is not painful, and the breast skin, nipples, and areola appear to be normal. There is no nipple di | The breasts are examined with the patient in sitting and supine positions. The breasts are small and symmetrical. The contour of each breast is smooth; there is no evidence of dimpling, retraction, or edema. The nipples and areola are pink-tan and non- |
| Which one of the following imaging techniques is indicated to evaluate this palpable breast mass: ultrasound, mammogram, or MRI? | Mammography is the imaging technique of choice to investigate a palpable breast mass in a woman age 35 and older. Ultrasound is the preferred test for women less than age 35 because the denser breast tissue on mammography makes it difficult to distinguis |
| The lesion pictured in the mammogram represents the most common benign tumor of the breast. What is it? | Fibroadenoma |
| Fibroadenomas usually have what appearance on mammography? | A fibroadenoma appears as a well-circumscribed mass with well-defined borders. Its borders are smooth and round, oval, or nodular. They are frequently multiple and bilateral. It typically has the appearance of a dense, popcorn-like calcification on mam |
| A 71 year old female presents with a mass in the upper, outer portion of her left breast. She first noticed the mass “several months ago” while bathing. She did not seek medical attention at the time because “I thought it would just go away if I left it | The breasts are examined with the patient in sitting and supine positions. The breasts are large, pendulous, and asymmetric. The left breast is larger than the right breast, showing fullness in the upper, outer quadrant. The skin of the upper, outer qu |
| What is the most common type of breast cancer? | Invasive ductal carcinoma, which arises from the epithelium of the breast ducts, accounts for nearly 94% of breast cancers. Invasive lobular carcinoma arises from the acini of breast lobules and accounts for 5.5% of cases. Less than 1% of invasive breas |
| What is the most common mammographic appearance of invasive carcinoma? | A spiculated mass is the most common mammographic appearance. In addition, microcalcifications may be seen on mammography in at least 30% of cases of invasive carcinoma. The calcifications represent necrotic debris. |
| Several benign breast conditions can produce a spiculated density, which may be indistinguishable on mammography from carcinoma. List some of these benign conditions. | Post-biopsy scarring, traumatic fat necrosis, breast abscess, sclerosing adenosis, or a radial scar can all potentially be seen as a spiculated density. |
| A 40 year old female presents to clinic asking for a mammogram. She is a healthy, active woman with a medical history significant only for hypothyroidism and cholecystectomy at age 35. She is a homemaker and mother of 2 children. She has never smoked c | The breasts are examined with the patient in sitting and supine positions. The breasts are large, round, and symmetrical. The contour of each is smooth with no evidence of dimpling, retraction, or edema. The nipples and areola are symmetrical, pink-tan |
| What are the current recommendations for breast cancer screening with mammography? | The 2002 U.S. Preventive Services Task Force (USPSTF) recommends screening mammography every 1-2 years for women aged 40 and older. The USPSTF found evidence that mammography screening every 1-2 years significantly reduces mortality from breast cancer. |
| What images does a standard screening mammogram consist of? | The standard mammographic examination consists of a mediolateral oblique view (MLO) and a craniocaudal view. |
| Estimate the accuracy (sensitivity and specificity) of mammography as a screening test. | The sensitivity of mammography is 77%-95%, while the specificity is 94%-97%. Sensitivity is lower among women who are less than 50 years old, have denser breasts, or are taking hormone replacement therapy. Specificity is increased with a shorter screeni |
| What potential harms can occur from screening for breast cancer with mammography? | The large majority of abnormal screening mammograms are false-positives. These may require invasive follow-up procedures such as unnecessary breast biopsies to resolve diagnosis, which can result in anxiety, inconvenience, and additional medical expenses |
| Is there a potential risk for radiation-induced breast cancer in women who receive annual mammograms? | The risk estimate provided by the Biological Effects of Ionizing Radiation report estimated that annual mammography of 100,000 women for 10 consecutive years beginning at age 40 would result in up to 8 radiation-induced breast cancer deaths. This risk is |
| which vitamin supplement reduces symptoms of breast edema and tenderness | vitamin E |
| gynecomastia | the enlargement of one or both breasts in a male |
| montgomery's tubercles | slightly raised bumps on the areolar tissue |
| paget's disease | a rare type of breast cancer characterized by a red, scaly nipple with discharge and crusting that lasts more that a few weeksz |
| inframammary ridge | a firm transverse ridge along the lower edge of the breastz |
| ductal ectasiaz | a benign breast disease characterized by inflammation and dilation involving one or more multiple subareolar ducts. initial symptom is a sticky dipple discharge that is commonly dark green or blackz |
| intraductal papillomaz | a small, benign, wartlike tumor growth in the major ducts usually within 1 to 2 cm of the areolar edge. Usually has a spontaneous bloody discharge from the nipple and an occasional mass |
| invasive breast cancer | the most common type of breast cancer arising from the ducts or the lobules |
| mastitis | an inflammatory condition of the breast usually caused by a bacterial infection. Usually occurs secondary to milk stasis or a plugged duct |
| galactorrhea | inappropriate lactation. Causes include endocrine-related disorders and side effects of alot of medications |
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