Flashcards in Lesson 3A (Part 4) Deck (30)
Retro mammary fat
What does normal lactating breast tissue have?
Prominent fluid filled ducts and their echogenic epithelial lining is readily visible
What is the key area to scan because you typically find cancer here?
Tail of spence
What quadrant is the most common pace for cancer in the breast?
Upper outer quadrant
What kind of frequency transducer do you use for breast?
- wide footprint probe
When do you use lower frequency transducer? (3)
1. Larger attenuative breasts
2. Inflammatory masses
What kind of technique can you use for scanning the nipple, superficial/or skin lesions?
What kind of doppler is used for assessing vascularity of lesions? (2)
1. Low PRF
2. Spectral doppler
How should mammary fat appear sonographically?
- from the overlying fascia to the retromammary space
What should patient history include for scanning the breast? (12)
1. Family history
3. Previous mammograms
9. Skin changes
11. Nipple discharge
12. Surgeries of the breast
What position do you scan your patient when doing an exam for the breast? (2)
2. Ipsilateral arm over the patients head
When do you increase the transducer pressure when scanning the breast? (2)
1. Greater penetration
2. Scanning the subareolar region
What are 4 techniques when scanning the breast?
1. Maximize tissue thinness
2. Reduce reflective and refractive attenuation
3. Maintain ultrasound transducer parallel to breast surface
4. Maintain ultrasound beam perpendicular to breast tissue
What can a shadow be caused by the breast?
The erection of the nipple
How can you decrease the shadow caused by the nipple? (3)
1. Apply more pressure
2. Use more gel
3. Scan the nipple area obliquely
What is the benefit for scanning the nipple region obliquely? (3)
1. Reduces the shadowing
2. Avoids the need for a standoff pad
3. Provides adequate visualization of the anatomy posterior to the nipple
Is a pea or bee-bee sized, then it is very small and near the skin
Whats the best way to visualize a palpable nodule?
Use a 1 cm standoff pad or a large "glop" of gel in order to move the elevation plane focus closer to the skin
What is the most common scanning technique for the breast?
Initially scan using the grid scanning pattern, followed by a radial (clock face) technique for the hard copy imaging
How do you scan the breast in a grid pattern? (4)
1. Begin in the upper outer quadrant, scanning in transverse
- slide inferiorly from top to bottom
2. Move across and repeat the sweep inferior to superior
3. Repeat this across the breast
4. Rotate into a sagittal plane and repeat the pattern
What is the number one modality for examining the breast?
- US helps confirm it
When do you use US instead of mammography? (4)
1. Below age 40
2. Pregnant or lactating
3. Someone who is young
How does cartilage appear on US?
How does bone appear on US?
What kind of vascularity should there be in a lactating breast?