Lesson 3C (Part 5)

Question 1

What does carcinoma in-situ indicate?

Answer 1

That the cancer is still contained entirely with the tissue of origin and has not penetrated the tissue boundaries
- a histological diagnosis)

Question 2

LCIS

Answer 2

Lobular Carcinoma In-Situ

Question 3

Lobular Carcinoma In-Situ

Answer 3

Not a true cancer

- marker of significant increased future risk of developing cancer

Question 4

What does LCIS arise from?

Answer 4

Small ducts of breast lobule

- multicentric, bilateral

Question 5

What is the most common invasive cancer?

Answer 5

Ductal Carcinoma In-Situ

Question 6

DCIS

Answer 6

Ductal Carcinoma In-Situ

Question 7

What kind of cancer is DCIS considered?

Answer 7

Intraductal carcinoma

Question 8

Intraductal carcinoma

Answer 8

Cancer originated within breast milk ductal epithelium and is still contained by the ductal walls

Question 9

What age group is DCIS more common in?

Answer 9

50 year olds

Question 10

How does DCIS look on US?

Answer 10

Microcalcifications contained within the distended duct or hypoechoic mass

Question 11

What do 97% of patients with Pagets diseaes of the nipple have?

Answer 11

An underlying breast cancer

Question 12

What are the signs and symptoms of pagets disease of the breast? (4)

Answer 12

1. Eczema-like rash around the nipple/areola
2. Nipple discharge
3. Itching/tingling
4. Hypersensitivity of the nipple

Question 13

Where do most paget related breast cancers begin?

Answer 13

In the ducts behind the nipple

Question 14

What are good modalities for paget disease of the breast? (2)

Answer 14

1. Mammography

2. Breast MRI

Question 15

Infiltrating

Answer 15

Cancer has crossed multiple tissue boundaries, and is no longer contained in the tissue of origin

Question 16

What kind of growth patterns do infiltrating lobular carcinoma have?

Answer 16

Diffuse growth pattern

Question 17

How does ILC appear on US? (4)

Answer 17

1. Non specific parenchymal thickening
2. Irregular
3. Illdefined hypoechoic solid mass
4. Shadowing

Question 18

What is the most common type of breast cancer?

Answer 18

Infiltrating ductal carcinoma

- IDC

Question 19

Where is IDC most common located?

Answer 19

Upper outer quadrant

Question 20

What does medullary carcinoma have compared to ductal or lobular carcinoma?

Answer 20

Better defined margins

- so is has a better prognosis

Question 21

How does colloid carcinoma appear on US? (5)

Answer 21

1. Round or oval
2. Circumscribed mass
3. Lobulation or microlobulation
4. Isoechoic or hypoechoic compared to fat
5. Homogeneous or mild heterogeneous echo pattern

Question 22

What is another term for colloid carcinoma?

Answer 22

Mucinous carcinoma

Question 23

How does tubular carcinoma appear on US? (4)

Answer 23

1. Small irregular
2. Centrally hypoechoic mass
3. Frank spiculation
4. Surrounded by thick echogenic halo

Question 24

What happens to Coppers ligaments with tubular carcinoma?

Answer 24

They become thick and straight and may cause skin retraction

- this is key

Question 25

Inflammatory breast cancer

Answer 25

The cancer blocks the lymphatic drainage of the cutaneous tissues.
- rare but aggressive

Question 26

What kind of signs come with inflammatory breast cancer? (3)

Answer 26

1. Reddened
2. Swollen
3. Firm breast in the absence ofinfection

• unexplained onsets

Question 27

What kind of appearance do you get with inflammatory breast cancer?

Answer 27

Peau d’orange appearance

- orange peel

Question 28

What is the sonographic appearance of inflammatory carcinoma? (3)

Answer 28

1. Microcalcifications
2. Thickened skin
3. Large axillary lymph node metastes

Question 29

Where is the first sight of spread from primary breast cancer?

Answer 29

Is to the ipsilateral axillary lymph nodes

Question 30

What is the first node in drainage basin?

Answer 30

Sentinel node

- at most risk for metastasis

Question 31

What does cancer spread to through the bloodstream? (4)

Answer 31

1. Bone
2. Liver
3. Lung
4. Brain