Breast Pathology/Benign -- Exam 2

benign pathology

athelia

absence of nipple

congenital

born with

amastia

absence of breast tissue

supernumerary breast/nipple

more than one

polymastia

extra breast tissue

inverted nipples

very common and can make it difficult to breast feed

mammary milk line

where nipples/tissue can form down the abdomen

what is the role of sonography

to distinguish between cystic and solid structures and characterize breast masses

what is fremitus

a technique to outline the borders of a mass

using the power doppler and fremitus technique, what is able to be seen

it will show blood flow everywhere but the mass, it helps delineate the exact border of mass

what does the patient have to do with the fremitus technique

hum

color doppler

blood flow, red and blue

if the patient is young, where will palpable masses be examined first

ultrasound

what are benign appearances

round, smooth borders, compressible, mobile, tender/change, solid mass homogenous, and acoustic enhancement

what are malignant appearances

painless, lobular, irregular border, taller than wide, fixed, shadowing, heterogenous, vascular

cyst containing a milky substance that is usually located in the mammary glands

galactocele

is a galactocele benign or malignant

benign

echogenic material inside the cyst that can cause fat-fluid level

lipid

what will shift the material to demonstrate leveling in lipid

adjusting patient position

what do you use to prove cystic in nature but not a solid mass

a color doppler

what is the most common breast disorder

fibrocystic changes

what are fibrocystic changes most common in

20-40yr olds

what does fibrocystic changes produce

histologic alterations in the ducts and lobules of the breast

lipid cyst

contains fat and can look like a complex cyst

Breast pain and tenderness, fluctuation under hormonal influence, and associated with cystic fibrosis formation are symptoms of

Fibrocystic changes

Fibrocystic Benign conditions causes:

Loss of breast lobules

What is the most common benign breast tumor

Fibroadenoma

Who do fibroadenomas commonly occur in

Young women

What does a fibroadenoma generally feel like

Firm, rubbery, freely mobile

What is a lipoma

A fat tumor

Who do lipomas commonly occur in

Middle aged or menopausal women

What type of breast tissue does a lipoma blend into

Fatty breast tissue

Fibroadenoma lipoma

Fibrous and fatty

What is the key to seeing a lipoma

The pressure of the transducer

What is fat necrosis caused by

Injury to the breast fat

Who is fat necrosis commonly found in

Older women

A nodule of fat necrosis is generally:

Superficial under a layer of calcified necrosis

What does fat necrosis appear as

Solid lesion, complex mass, anechoic mass with posterior enhancement or shadowing

Benign tumor that grows in the acini in the duct of the breast

Intraductal papilloma

What does intraductal papilloma commonly occur in

Women 30-55

What is the predominant symptom of intraductal papilloma

Buildup of fluid

Raspberry like appearance on mammogram

Refers to intraductal papilloma

How does intraductal papilloma appear on ultrasound

Complex cyst with separations or debris appearance on ultrasound

True/false: intraductal papillomas CAN become malignant

True

ACUTE mastitis

Results from infection, trauma, or obstruction of the DUCTS

What is acute mastitis often associated with

Lactation

Where id acute mastitis

Often confined to one area of the breast

Chronic mastitis

Inflammation of the glandular tissue of the breast

Symptoms of chronic mastitis

Nipple discharge and retraction

what can chronic mastitis lead to

An abscess

Acute abscess

Poorly defined border

Mature abscess

Well encapsulated with sharp borders

What are the clinical symptoms for an abscess

Pain, swelling, red skin, fever, swollen lymph nodes

Sign of an abscess on ultrasound

Increased vascularity

At what size do you biopsy a lymph node

Hilum to cortex measuring 2.5cm