Ch. 21 Breast

ACR

American college of radiation

accredits facilities

responsible for the BIRADS classification system

Adipose tissue

fat; fat in breast tissue appears hypoechoic

fatty breasts are usually seen in older people

What transducer and frequency is used for breast imaging?

Linear array- at least 10 mHz

Antiradial

against the clock hands

perpendicular to the radial scan plane.

Areola

pigmented skin on the breast surface surrounding the nipple

Axilla

armpit

majority of breast masses occur here

where the lymph nodes drain into

Breast

main function is to secrete milk during lactation

modified sweat gland

BIRADS

used to describe and classify breast masses

developed by the ACR

overall outcome assessment category that indicates suspicion of malignancy

Breast Self Examination (BSE)

self performed monthly

should begin at age 20 and at end of menses

Clinical Breast Examination (CBE)

clinically performed

Clock face documentation system

involves viewing each breast as a clock face.

scan radially clockwise

specific location of a mass would be described according to the position on a clock

Cooper’s Ligaments/ Connective tissue

connective tissue septa w/in the breast that form a fibrous “skeleton”

responsible for maintaining shape & structure of the breast.

connects to the fascia around the ducts & glands and extends out to the skin

Cyst Aspiration

a procedure used to:

drain fluid from a cyst, diagnose a cyst, Alleviate symptoms or discomfort.

used to determine cyst vs mass

sm needle to draw out fluid from the breast

Dense Breast

ultrasound used for people under the age of 30

found in younger men and women, and pregnant or lactating women

difficult to visualize with mammography

Ductal Ectasia

dilated duct

Elastography

part of the BIRADS

compressibility of the mass

stiffer = more suspicious

Feeding vessel

could be a suspicious finding

part of the BIRADS

Fibroadenoma

most common benign solid tumor of the breast

Fremitus

using color and having a pt hum to outline a mass in the breast

causes the tissues to vibrate without affecting the mass

Gold standard of breast imaging

mammography

Gynecomastia

enlargement of the male breast.

Infiltrating (invasive) ductal carcinoma (IDC)

most common type of breast cancer

usually arises in the TDLU’s

Fatty Breast

found in older people

better for mammography

diffucult for ultrasound

Lactation

secretion of milk during and after pregnancy

creates dense breast tissue

Mammary layer

middle layer of breast.

Functional layer

contains the TDLUs

most pathology occurs here

Mammogram

gold standard for breast imaging

poor for dense breast, better for seeing calcifications

Prolactin

hormone that stimulates milk production

Radial

with the clock hands

more suspicious for cancer b/c the glandular tissue and ducts follows the radial plane.

Tail of Spence

extension of the axillary tail into the breast region

Terminal Ductal Lobular Unit (TDLU)

nearly all pathology occurs here

located in the mammary layer

the terminal ends of the duct and the acini to form small lobular units.

Cancer within breast tissue appears?

hypoechoic

Why are radial masses suspicious for cancer?

Because cancer follows the ducts

Clinical findings of breastfeeding disease?

Pain- with or without a palpable mass

Spontaneous or induced nipple discharge, skin dimpling, ulceration, and nipple retraction

Ductal carcinoma in situ

Most common non-invasive breastfeeding malignancy