Lesson 3C (Part 4)

Question 1

What are adenomas primarily made of?

Answer 1

Glandular elements

Question 2

What do adenomas secrete?

Answer 2

Lactation

Question 3

How are adenomas seen on US? (4)

Answer 3

1. Oval
2. Circumscribed solid mass
3. Areas of increased echogenicity
4. Prominent vascularity

Question 4

WHat are phylloide tumours also called?

Answer 4

Phyllodes

Question 5

What kind of appearance are phyllodes very similar to?

Answer 5

Fibroadenomas

- has cystic spaces

Question 6

How do phyllodes normally grow?

Answer 6

Rapidly

Question 7

What is the size of a phyllodes?

Answer 7

Greater than 5cm

Question 8

What age group are phyllodes more common?

Answer 8

40 year old +

Question 9

What is the most common breast sarcoma?

Answer 9

Phylloides tumours

Question 10

What is recommended with phylloide tumours?

Answer 10

Core biopsy

- it is poorly differentiated by fine needle biopsy

Question 11

Hamartoma

Answer 11

Mass made of varying amounts of normal or dysplastic fibrous, epithelial, and fatty breast tissues

Question 12

Where do you find hamartomas?

Answer 12

Within the mammary zone

Question 13

How do hamartomas appear on US? (3)

Answer 13

1. Circumscribed oval mass
2. Mixed echo patterns
3. Thin echogenic pseudocapsule

Question 14

Lipoma

Answer 14

Benign nodule of mature adipose tissue surrounded by a thin connective tissue capsule

Question 15

How do lipomas grow?

Answer 15

Slowly

Question 16

What is the size of lipoma?

Answer 16

2-10 cm

Question 17

How do lipomas appear on US? (3)

Answer 17

1. Smooth walled
2. Thinly encapsualted nodule
3. Isoechoic or hyperechoic to adjacent normal fat

Question 18

Papilloma

Answer 18

Fibrovascular growths within milk ducts behind the nipple

Question 19

What does papilloma refer to?

Answer 19

The milk ducts

Question 20

How do papilloma appear on US? (2)

Answer 20

1. Circumscribed

2. Isoechoic to hypoechoic solid mass

Question 21

Where do you find papilloma?

Answer 21

Subareolar region

Question 22

Who do you find juvenile papillomatosis in?

Answer 22

Young females

Question 23

What do juvenile papillomatosis appear on an US? (4)

Answer 23

1. Focal ill defined
2. Heterogeneous mass
3. Contains several small peripheral cysts
4. Swiss cheese appearance

Question 24

What are risk factors fro breast cancer in women? (12)

Answer 24

1. Advancing age
2. First degree relative with breast cancer
   - eg) mom
3. Genetic predisposition
   - BRCA1 or BRCA2 gene
4. Early menarche
5. Late menopause
6. Nullipartiy
7. First full term pregnancy after the age of 30
8. Personal history of breast, ovarian or endometrial cancer
9. Obesity/increased BMI
10. High breast tissue density
11. Long term or high dosage of estrogen replacement therapy
12. Prior radiation to breast area
    - as in treatment for Hodgkin’s disease

Question 25

What are 10 malignant invasive breast diseases?

Answer 25

1. Infiltrating ductal carcinoma
   - IDC
2. Infiltrating lobular carcinoma
   - ILC
3. Medullary
4. Mucinous
5. Tubular
6. Inflammatory
7. Lymphoma
8. Metastases
9. Multifocal
10. Multicentric

Question 26

What are 3 malignant non invasive breast diseases?

Answer 26

1. DCIS
2. LCIS
3. Pagets

Question 27

Multi focal

Answer 27

Presence of additional malignant lesions within a breast quadrant or within 5cm of the primary tumor

Question 28

What does multifocal indicate?

Answer 28

Spread of cancer via the ducts

Question 29

ROI

Answer 29

Range of interest

Question 30

Multi centric

Answer 30

Coexistent cancers within different quadrants or seperated by more than 5cm within the breast

Question 31

What must you always remember with breast cancer grading and specific differentiation?

Answer 31

That is must involve a series of investigations and not be based on ultrasound alone