Lesson 3A (Part 3)

Question 1

What is the inverted nipple due to?

Answer 1

Cancer

- can be congenital

Question 2

Micromastia

Answer 2

Abnormal smallness of the breast

Question 3

Macromastia

Answer 3

Excessive size of the breasts

Question 4

What is the sonographic anatomy of the breast? (9)

Answer 4

1. Skin
2. Retromammary fat
3. Subcutaneous fat
4. Pectoralis muscle
5. Breast parenchyma
6. Ribs/pleura
   - mammary zone
7. Nipple region
8. Copper’s ligaments
9. Tail of Spence

Question 5

How does the skin appear sonographically?

Answer 5

A highly reflective band along the surface of the breast

- near field

Question 6

What is the normal thickness of the skin of the breast?

Answer 6

2-3mm

Question 7

Where does the subcutaneous fat lie?

Answer 7

Between the skin and the breast parenchyma

- mammary zone

Question 8

Is subcutaneous fat homogenous or heterogenous?

Answer 8

Homogenous

Question 9

What does coopers ligaments arise from?

Answer 9

Breast parenchyma

- extend radially from the deep fascial planes to the skin

Question 10

What kind of structures are cooper ligaments?

Answer 10

Tent like structures

Question 11

What is the echogenicity of coopers ligament?

Answer 11

Echogenic

Question 12

Where does parenchyma lie?

Answer 12

Beneath the subcutaneous fat

Question 13

What is the echogenicity of parenchyma?

Answer 13

Mixed homogeneity

Question 14

What are the 4 patterns of echogenicity of parenchyma?

Answer 14

1. Fibrous
2. Premenstrual
3. Postmenstrual
4. Pregnant

Question 15

Where is retromammary fat located?

Answer 15

Posterior to parenchyma

Question 16

What does the retromammary fat form?

Answer 16

A layer between the deep fascia plane and the pectoralis muscle

Question 17

Where is the pectoralis muscle situated?

Answer 17

Anterior to ribs

Question 18

What do you want to see on you US when scanning the pectoralis muslce?

Answer 18

Ribs

- this tells you that you have done a full sweep of the tissue

Question 19

How do ribs appear sonographically?

Answer 19

Appear as hypoechoic structures containing low-level echoes that attenuate causing an acoustic shadow

Question 20

Pleura

Answer 20

Linear echogenic line deep to rib

Question 21

When does the pleura move?

Answer 21

With respiration

Question 22

What does the nipple consist of?

Answer 22

Both dense connective tissue and connective tissue of
the duct
- can cause posterior acoustic shadowing

Question 23

Tail of spence

Answer 23

Is the portion of the breast that extends into the axillary region

Question 24

What is the sonographic appearance of lymph nodes? (3)

Answer 24

1. Solid nodule
2. Ovoid
3. Echogenic fatty hilum

Question 25

Ducts

Answer 25

Tubular branching structures

Question 26

What does breast density refer to?

Answer 26

Relative amount of fibroglandular tissue to fatty tissue

Question 27

What does high breast density mean?

Answer 27

There is a greater amount of breast and connective tissue compared to fat

Question 28

What does low breast density mean?

Answer 28

There is a greater amount of fat compared to breast and connective tissue

Question 29

What are the normal breast tissues? (3)

Answer 29

1. Premammary zone
2. Mammary zone
3. Retro-mammary zone

Question 30

Premammary zone

Answer 30

Skin and overlying breast fat

Question 31

Mammary zone

Answer 31

Fibroglandular tissue

Question 32

Retro-mammary zone

Answer 32

Predominantly fat and the muscles of the chest wall