MTMI Breast Review questions with correct answers., Exams of Nursing

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MTMI Breast Review questions with correct

answers

Reading MLO/CC Answer✓✓ MLO - superior (top of image) to inferior CC - lateral to medial mastitis untreated leads to Answer✓✓ abscess what types of cancer are very treatable Answer✓✓ noninvasive and intraductal most common noninvasive CA Answer✓✓ Ductal Carcinoma In Situ Paget's Disease Answer✓✓ a form of breast malignancy characterized by infiltration of the nipple epidermis by malignant cells clinical presentation of Paget's Answer✓✓ Eczematous appearing changes of the nipple include reddening, scaling, hyperkeratosis, and crusting of the nipple surface. Paget's mammographic presentation Answer✓✓ Mammary Paget disease can be undetectable on mammography in ~50% of cases 2. Features that may be evident on mammography include skin thickening, nipple retraction, subareolar or more diffuse malignant microcalcifications, and discrete subareolar mass(es). most common INVASIVE CA Answer✓✓ Invasive Ductal CA most common breast CA Answer✓✓ Invasive ductal carcinoma

sound wave classification Answer✓✓ mechanical, longitudinal, compressional breast ultrasound frequency Answer✓✓ 7.5 - 18 MHz start with heighest and work your way down wavelength and frequency are ______ related Answer✓✓ inversely related average speed of sound Answer✓✓ 1.54 mm/Us or 1540 m/s Increased attenuation with Answer✓✓ higher frequency greater distance gas/solid decreased attenuation with Answer✓✓ liquids failure of regression of mammary milk line results in Answer✓✓ accessory nipple along the line or ectopic breast tissue most common breast variant Answer✓✓ polythelia (most commonly inferior to) polythelia Answer✓✓ accessory nipples amazia Answer✓✓ Absence of breast tissue with development of the nipple.

lactiferous sinus Answer✓✓ where milk accumulates during nursing posterior to nipple normal duct size Answer✓✓ < 3 mm duct layers Answer✓✓ endothelial - smooth for transportation myoepithelial - movement of milk where on the breast is there muscle Answer✓✓ nipple - erectly muscles to allow contraction for milk to be emptied from lactiferous sinus Montgomery's glands Answer✓✓ sebaceous glands in the areola, secrete protective lipid during lactation; also called tubercles of Montgomery 4-28 in each breast sonographic appearance posterior to nipple Answer✓✓ acoustic shadow, vascular, could be mistaken as mass anterior mammary fascia is in between Answer✓✓ subcutaneous fat and mammary layer posterior mammary fascia is in between Answer✓✓ mammary layer and retromammary fat most breast cancers spread through Answer✓✓ axillary lymph nodes

distant breast metastasis would be found in Answer✓✓ supraclavicular/cervical lymph nodes linger/lung normal skin thickness Answer✓✓ 2-3 mm brightest breast tissue Answer✓✓ glandular/connective tissue a nulliparity breast would have more or less glandular tissue Answer✓✓ more after having kids, the breast is fattier what pathology is commonly seen in subcutaneous/premammary layer? Answer✓✓ lipoma, sebaceous cyst mammary fascia is more or less resistant to invasive malignancy Answer✓✓ more resistive d/t more dense tissue compared to loose stroma in mammary layer what is seen in retromammary layer? Answer✓✓ fat, blood vessels, lymphatics fibrofatty breast sono appearance Answer✓✓ sparse glandular tissue, primarily fat primarily hypoechoic indicating mostly fat fibroglandular v fibrofatty Answer✓✓ more glandular tissue in fibroglandular, more fatty tissue in fibrofatty

3 or less macrolobulations finding with the highest positive predictive value of malignancy Answer✓✓ spiculations on mammogram malignant contour Answer✓✓ spiculations taller > wide radial projections toward nipple angular multiple microlobulations ( < 90*) malignant borders Answer✓✓ thick, echogenic halo desmoplastic reaction shadowing posteriorly a benign tumor would be _______ to chest wall Answer✓✓ parallel a malignant tumor would be ________ to chest wall Answer✓✓ perpendicular echogenicity in benign finding Answer✓✓ anechoic mildly hypoechoic hyperechoic echogenicity in malignant finding Answer✓✓ markedly hypoechoic mildly hypoechoic

isoechoic compressibility of malignant tumor Answer✓✓ incompressible fixed position (nonmobile) rigid, very firm a malignant finding on mammo is most likely radiopaque or radiolucent Answer✓✓ radiopaque angiogenesis Answer✓✓ tumors create new blood vessels to feed it (malignant finding) Pulsed wave doppler characteristics in malignant finding Answer✓✓ higher PSV, lower EDV Pulsed wave doppler characteristics in benign finding Answer✓✓ low PSV, more rounded peaks (10-20 cm/s) causes of duct ectasia (dilatation) Answer✓✓ > 3 mm pregnancy, lactation, mastitis, menopause, fibrocystic change, internal mass breast skin thickening Answer✓✓ > 2 mm except for periareolar area and inframmammary folds < 4 mm Breast Imaging should be > _____ MHz Answer✓✓ 9 MHz

B - scattered fibrograndular C - heterogeneously dense D - extremely dense risk of breast cancer increases with ______ breast density Answer✓✓ increased in the CC view, the breast is compressed from Answer✓✓ superior to inferior in the MLO view, the breast is compressed from Answer✓✓ medial to lateral degree of obliquity of MLO view Answer✓✓ 30 - 60 * MULD Answer✓✓ medial up lateral down degree of pt rolled up for evaluation of outer region Answer✓✓ 30-45% angle echopalpation Answer✓✓ pressure applied to breast tissues with the probe while simultaneously viewing the image on the screen - assesses mobility/compression well showing may be seen posterior to nipple/coopers ligaments in this situation Answer✓✓ too little gel, too little pressure edge shadowing Answer✓✓ refraction artifact caused by the curved surface of the reflector

working around edge shadowing Answer✓✓ change angle to regain perpendicular incidence (heel toe_ to make sure there is no patho in shadow) what artifact causes the needle to appear bent in a cyst? Answer✓✓ refraction how to fix refraction of biopsy needle? Answer✓✓ regain perpendicular incidence heel toe most common imaging finding Answer✓✓ cysts microcysts Answer✓✓ < 2 mm focus on largest, most suspicious cysts galactocele Answer✓✓ milk-filled cyst with complex/complicated apperance occurs after cessation of lactation mammographic appearance of galactocele Answer✓✓ radiolucent due to high fat content, mimics lipoma appearance depends on amount of fat/proteinaceous material of milk galactocele on ultrasound Answer✓✓ circumscribed with low level echoes, fluid- fluid level may be present posterior enhancement may be present may see it layer live

most common solid benign tumor Answer✓✓ fibroadenoma who are fibroadenomas more prevalent in? Answer✓✓ < 35 y/o, African American Fibroadenoma growth is stimulated by: Answer✓✓ estrogen clinical signs of fibroadenoma Answer✓✓ firm, rubbery, mobile young age giant fibroadenoma Answer✓✓ > 5 cm Juvenile fibroadenoma Answer✓✓ Seen in adolescents and is characterized by very rapid growth women < 20 y/o but up to 72 Differential diagnosis for juvenile fibroadenoma Answer✓✓ phyllodes tumor phyllodes tumor Answer✓✓ Rapidly growing breast tumor most commonly dx at age 45 resembles fibroadenoma often have cystic components papilloma Answer✓✓ usually small, multiple, multicentric

35-55 y/o copious nipple d/c vascular stalk intraductal mass usually small < 1 cm large = isoechoic benign tumor arising from acini Answer✓✓ papilloma multiple papillomas develop within a group of ducts Answer✓✓ papillomatosis which is less known to cause discharge:papilloma or papillomatosis Answer✓✓ papillomatosis papillomatosis clinical findings Answer✓✓ younger patients asymptomatic does a papilloma or papillomatosis have greater malignant potential? Answer✓✓ papillomatosis ductal hyperplasia Answer✓✓ juvenile papillomatosis Juvenile papillomatosis Answer✓✓ Swiss cheese disease Rare condition affecting 30 y/o Cysts, duct ectasia, intraductal hyperplasia, and sclerosing adenosis

sonographic apperance of hamartoma Answer✓✓ same elements as surrounding tissue, but stands out if encapsulated no edge shadowing/enhancement may mimic fibroadenoma most common cause of mastitis Answer✓✓ staphylococcal infection during lactation puerperal mastitis Answer✓✓ bacterial infection of the breast puerperal mastitis symptoms Answer✓✓ tender, swollen breasts blocked ducts purulent discharge thick, red skin painful axillary nodes leukocytosis, possible fever sonographic findings of breast inflammation Answer✓✓ hypervascularity skin thickening edema cause: inflamed cyst or periductal mastitis complication of mastitis Answer✓✓ breast abscess breast edema could be due to Answer✓✓ systemic disorder such as CHF, renal failure

inflammatory breast cancer mastitis sonographic appearance of breast abscess Answer✓✓ complex hypo or anechoic mass thick walled round/oval indistinct margin bright specular reflections from air peripheral vascularity mammographic apperance of breast edema Answer✓✓ skin thickening/retraction increased density ultrasound apperance breast edema Answer✓✓ increased echogenicity of surrounding tissue blurred coopers ligaments dilated lymphatics/interstitial fluid noninfectious mastitis may present in Answer✓✓ diabetic or heavy smoker patients non-pyogenic/non-infectious symptoms are more subtle Granulomatous mastitis Answer✓✓ Rare benign inflammatory condition of unknown cause complete resection, corticosteroid therapy or both are necessary

hematoma sonographic findings Answer✓✓ hypoechoic. hyperechic reactive tissue along periphery what fluid collections are commonly seen post op? Answer✓✓ seroma and lymphocele mammographic apperance of fat necrosis Answer✓✓ oval mass of fat density radiolucent or mixed fat/soft tissue density calcified or noncalcified rim a lipid or oil cyst is called Answer✓✓ fat necrosis ultrasound of fat necrosis Answer✓✓ irregular, complex with low level echoes could appear similar to fat or carcinoma with shadowing radial scar age group Answer✓✓ 40- radial scar Answer✓✓ Benign lesion of the breast commonly presenting with a spiculated area of architectural distortion associated with central fat and long spiculations. Rarely produces a palpable mass. if a radial scar is > or equal to 2 cm it is termed Answer✓✓ complex sclerosing lesion radial scar on mammo Answer✓✓ architectural distortion spiculated mass

central density microcalcs may be appreciated radial scar on US Answer✓✓ spiculated, echogenic, may contain small cysts, posterior shadowing, similar appearance to low grade CA benign enlargement of lobule due to epithelial/stromal hyperplasia Answer✓✓ sclerosing adenosis diabetic mastopathy clinical findings Answer✓✓ women with long term insulin- dependent diabetes - about 20 yrs from onset diabetic mastopathy is Answer✓✓ stromal proliferation - Sequella of long term IDDM- autoimmune reaction to matrix proteins from chronic hyperglycemia can cause a firm and sometimes painful mass sonographic findings - diabetic mastopathy Answer✓✓ ill-defined, heterogeneous or hypoechoic marked posterior acousti shadowing PASH Answer✓✓ Pseudoangiomatous stromal hyperplasia. Unknown etiology. Stromal and epithelial proliferation, thought to be under hormonal control pseudo angiomatous stromal hyperplasia Answer✓✓ PASH - focal overgrowth of stromal tissue