ARDMS Breast questions with verified answers
2 secondary sources of blood supply to the breast tissues: Ans✓✓✓
Thoracoacrominal Artery (supply a superior region) and the Intercostal Artery
(supplying the inferior margin)
Abscess Ans✓✓✓ Abscess formation is a complication of lactational or non-
lactational mastitis. An abscess is typically found in the subareolar region, but may
develop anywhere in the breast tissue. Abscesses may require surgical drainage.
Acini Ans✓✓✓ Also called acinus or acinar cell
Smallest functional unit of the breast
Milk-producing gland
Hundreds of acini in each breast
Each acini gives rise to a ductule or terminal duct
Acute Mastitis presents with: Ans✓✓✓ Firm, tender, swollen breasts
Localized skin thickening and redness
Purulent nipple discharge
Tender axillary lymph nodes
Leukocytosis and fever
Advanced Breast Biopsy Instrument (ABBI) Ans✓✓✓ The advanced breast biopsy
instrument is a percutaneous biopsy procedure offering both diagnostic and
therapeutic treatment of breast mass. The ABBI uses a rotating circular knife to
remove a cylinder of tissue larger than a core needle biopsy and mammotomy
,Procedure: Pt lies in a prone position on a specially designed table with an
opening in the chest area. Used computer-guided, stereotactic mammography to
pinpoint the lesion. Through a 1/2 to 1 inch skin incision, the ABBI instrument is
advanced into the breast. A 2 cm core sample is removed. Attempt is made to
excise the entire lesion when possible. The specimen is examined for tumor
completeness. The breast is also re-examined mammographically to assure
complete removal.
**ABBI DOES NOT REQUIRE SONOGRAPHIC GUIDANCE.
Advantages of CAD: Ans✓✓✓ Ability to detect small microcalcifications and
spiculated masses (sometimes missed by radiologists)
Computer readings are reliable and consistent
Decreased human error
technology will continue to improve
*CAD should never be used as a diagnostic tool alone
*Radiologists should initially interpret the study then use CAD
*If CAD marks an additional area, the images should be re-evaluated to decide
whether follow-up is needed
Amastia Ans✓✓✓ absence of one or both breasts
Amazia Ans✓✓✓ absence of the breast tissue with development of the nipple
Anatomic layer (from superficial to deep) Ans✓✓✓ 1. Skin
2. Subcutaneous layer
,3. Mammary layer
4. Retromammary layer
5. Muscle layers (Pectoralis major and minor)
6. Chest wall (ribs and intercostal muscles)
Appearance of simple cysts- Mammography: Ans✓✓✓ Round or oval, smooth
margins, radiopaque-water density, halo sign (lucent rim of fat)
Appearance of simple cysts-Sonography: Ans✓✓✓ Round or oval, anechoic,
smooth margins, sharp borders, acoustic enhancment, may have edge shadowing,
occasionally lobulated, compressible, no internal doppler signal
Artifacts within a cyst may be due to: Ans✓✓✓ Improper TGC
Overall Gain too high
Improper focal position
small cyst size
Superficial location (use a standoff pad)
Deep location
Side or Grating lobe
Slice thickness artifact
Volume averaging artifact
Athelia Ans✓✓✓ Absence of the nipple
Axillary Lymph node chain Ans✓✓✓ Consists of 6 groups of nodes:
, 1)External Mammary group-located along the lateral thoracic vessels
2)Scapular group- run with the subscapular vessels
3)Axillary group- run with the axillary vessels
4)Central group-run with the axillary vessels
5) Subclavicular group- run with the subclavian vessels
6) Interpectoral (Rotter's) nodes- found between the pectoralis major and minor
muscles
Axillary lymph node dissection Ans✓✓✓ Removal and or sampling of the lymph
nodes
may be performed with lumpectomy or modified radical mastectomy
Metastatic progression of cancer through the axillary lymph nodes usually
proceeds in an orderly manner through level 1 (lateral to the pectoralis minor
muscle), level 2 (posterior to the pectoralis minor), then level 3 (medial to the
pectoarlis minor). Typically, surgeons perform a level 1 and level 2 ALND. If level 1
and level 2 nodes are cancer free, it is extremely unlikely level 3 nodes contains
mets. LYMPHEDEMA IS THE MOST COMMON COMPLICATION.
Benefits of MRI breast imaging: Ans✓✓✓ Creating image slices from any plane
Providing a landscape view
Demonstrating both breasts stimultaneously
Effectively evaluating dense breasts
Sensitivity to small lesions
Sensitivity to malignant lesions with use of Gadolinium
Detecting implant ruptures
Detecting residual cancer after lumpectomy
2 secondary sources of blood supply to the breast tissues: Ans✓✓✓
Thoracoacrominal Artery (supply a superior region) and the Intercostal Artery
(supplying the inferior margin)
Abscess Ans✓✓✓ Abscess formation is a complication of lactational or non-
lactational mastitis. An abscess is typically found in the subareolar region, but may
develop anywhere in the breast tissue. Abscesses may require surgical drainage.
Acini Ans✓✓✓ Also called acinus or acinar cell
Smallest functional unit of the breast
Milk-producing gland
Hundreds of acini in each breast
Each acini gives rise to a ductule or terminal duct
Acute Mastitis presents with: Ans✓✓✓ Firm, tender, swollen breasts
Localized skin thickening and redness
Purulent nipple discharge
Tender axillary lymph nodes
Leukocytosis and fever
Advanced Breast Biopsy Instrument (ABBI) Ans✓✓✓ The advanced breast biopsy
instrument is a percutaneous biopsy procedure offering both diagnostic and
therapeutic treatment of breast mass. The ABBI uses a rotating circular knife to
remove a cylinder of tissue larger than a core needle biopsy and mammotomy
,Procedure: Pt lies in a prone position on a specially designed table with an
opening in the chest area. Used computer-guided, stereotactic mammography to
pinpoint the lesion. Through a 1/2 to 1 inch skin incision, the ABBI instrument is
advanced into the breast. A 2 cm core sample is removed. Attempt is made to
excise the entire lesion when possible. The specimen is examined for tumor
completeness. The breast is also re-examined mammographically to assure
complete removal.
**ABBI DOES NOT REQUIRE SONOGRAPHIC GUIDANCE.
Advantages of CAD: Ans✓✓✓ Ability to detect small microcalcifications and
spiculated masses (sometimes missed by radiologists)
Computer readings are reliable and consistent
Decreased human error
technology will continue to improve
*CAD should never be used as a diagnostic tool alone
*Radiologists should initially interpret the study then use CAD
*If CAD marks an additional area, the images should be re-evaluated to decide
whether follow-up is needed
Amastia Ans✓✓✓ absence of one or both breasts
Amazia Ans✓✓✓ absence of the breast tissue with development of the nipple
Anatomic layer (from superficial to deep) Ans✓✓✓ 1. Skin
2. Subcutaneous layer
,3. Mammary layer
4. Retromammary layer
5. Muscle layers (Pectoralis major and minor)
6. Chest wall (ribs and intercostal muscles)
Appearance of simple cysts- Mammography: Ans✓✓✓ Round or oval, smooth
margins, radiopaque-water density, halo sign (lucent rim of fat)
Appearance of simple cysts-Sonography: Ans✓✓✓ Round or oval, anechoic,
smooth margins, sharp borders, acoustic enhancment, may have edge shadowing,
occasionally lobulated, compressible, no internal doppler signal
Artifacts within a cyst may be due to: Ans✓✓✓ Improper TGC
Overall Gain too high
Improper focal position
small cyst size
Superficial location (use a standoff pad)
Deep location
Side or Grating lobe
Slice thickness artifact
Volume averaging artifact
Athelia Ans✓✓✓ Absence of the nipple
Axillary Lymph node chain Ans✓✓✓ Consists of 6 groups of nodes:
, 1)External Mammary group-located along the lateral thoracic vessels
2)Scapular group- run with the subscapular vessels
3)Axillary group- run with the axillary vessels
4)Central group-run with the axillary vessels
5) Subclavicular group- run with the subclavian vessels
6) Interpectoral (Rotter's) nodes- found between the pectoralis major and minor
muscles
Axillary lymph node dissection Ans✓✓✓ Removal and or sampling of the lymph
nodes
may be performed with lumpectomy or modified radical mastectomy
Metastatic progression of cancer through the axillary lymph nodes usually
proceeds in an orderly manner through level 1 (lateral to the pectoralis minor
muscle), level 2 (posterior to the pectoralis minor), then level 3 (medial to the
pectoarlis minor). Typically, surgeons perform a level 1 and level 2 ALND. If level 1
and level 2 nodes are cancer free, it is extremely unlikely level 3 nodes contains
mets. LYMPHEDEMA IS THE MOST COMMON COMPLICATION.
Benefits of MRI breast imaging: Ans✓✓✓ Creating image slices from any plane
Providing a landscape view
Demonstrating both breasts stimultaneously
Effectively evaluating dense breasts
Sensitivity to small lesions
Sensitivity to malignant lesions with use of Gadolinium
Detecting implant ruptures
Detecting residual cancer after lumpectomy
