Breast pathology ARDMS
Most common diffuse breast disorder - ANSWERFibrocystic disease
Most common cause of palpable finding in the breast - ANSWERFibrocystic disease
Fibrocystic disease affects females age - ANSWER20-40 yrs
Symptoms of fibrocystic disease - ANSWERCyclic bilateral breast pain related to menses and palpable lumps
Reducing ___ can reduce breast swelling and soreness in the normal breast - ANSWERReducing the amount of
caffeine intake
If bilateral milky to greenish tint nipple discharge occurs it is considered - ANSWERNormal
Histologic changes occur in the terminal ducts and lobules with - ANSWERThe monthly hormone cycle
Cyclic changes where increased estrogen stimulates the proliferation of these normal structures and then
resorption occurs when estrogen levels drop
Fibrocystic disease leads to - ANSWEREnlarged lobules
Cysts
Stromal fibrosis
Ductal hyperplasia
Ductal ectasia/dilatation
,Women with moderate hyperplasia have - ANSWER1.5-2 times greater risk of developing breast cancer
Women with atypical ductal or lobular hyperplasia have - ANSWER3.5-5 times greater risk of developing
breast cancer
______ responsible for nearly 50% of all surgical procedures performed on the breast - ANSWERFibrocystic
disease
Mammo graphic appearance of fibrocystic disease - ANSWEREnlarged lobules lead to increased density of the
affected tissue
May see bilateral rounded water densities=multiple cysts
Sonographic appearance of fibrocystic disease - ANSWERAverage amount of subcutaneous fat with enlarged
lobules
Fibrous stromal areas appear brighter than parenchyma
Small cysts scattered throughout the br warn
Large cysts may also be present
Ductal dilatation(>3mm)
Benign breast proliferative disorder associated with fibrocystic disease - ANSWERPapillary Apocrine
Metaplasia (PAM)
Physiologic cause of visible change in TDLU size - ANSWERPapillary apocrine metaplasia
Pam can present as - ANSWERDiffuse enlargement of the lobules throughout the breast
,Pam can be associated with - ANSWERNipple discharge
Lack of dilated ducts and identifiable papilloma usually indicate nipple discharge related to PAM
When PAM occurs as a cystic structure - ANSWERLow level internal echoes within cyst
May have stringy or nodular appearance
Acorn cyst - ANSWERMural nodule or eccentrically thickened wall caused by PAM, cyst appears to have a cap
like and acorn
Position of PAM - ANSWERDoes not shift within the cyst with change in patient position
Cyst aspiration of PAM - ANSWERCyst will not be aspirated completely leaving the appearance of a mural
nodule
Mural nodules in a cyst are more commonly caused by? - ANSWERPAM than papilloma (benign or malignant)
PAM mural nodules appear - ANSWERUniformly hypoechoic, stringy and lacy
(While papilloma nodules are usually echogenic, heterogenous and coarse)
Papillomas usually connect to the cyst wall with a stalk or angular margin whereas PAM nodules have -
ANSWERA smooth connection along thin capsule of cyst
Papillomas usually demonstrate microlobulations of the inner wall while PAM nodules usually demonstrate -
ANSWERA smooth internal margin
PAM has - ANSWERNo blood flow
, Papilloma nodules have - ANSWERInternal flow
Most common breast lesion? - ANSWERSimple cyst
Most common cause of palpable lump? - ANSWERSimple cyst
Simple cysts are commonly seen in - ANSWERPremenopausal women
35-50yrs old
Simple cyst commonly associated with - ANSWERFibrocystic changes
Simple cysts can persist in postmenopausal women with - ANSWERHRT
Certain HTN medications and
Steroid therapy
Simple cysts may be - ANSWERSingle or multiple
Microcystic or macrocystic
Simple cyst originate - ANSWERIn the TDLU due to obstructed ductal outflow from the lobule
Clinical symptoms of simple cyst - ANSWERRecent lump and Recent tenderness that changes with menstrual
cycle; lump usually compressible and moveable
Mammographic appearance of simple cyst - ANSWERWater density
Round shake with smooth borders
Most common diffuse breast disorder - ANSWERFibrocystic disease
Most common cause of palpable finding in the breast - ANSWERFibrocystic disease
Fibrocystic disease affects females age - ANSWER20-40 yrs
Symptoms of fibrocystic disease - ANSWERCyclic bilateral breast pain related to menses and palpable lumps
Reducing ___ can reduce breast swelling and soreness in the normal breast - ANSWERReducing the amount of
caffeine intake
If bilateral milky to greenish tint nipple discharge occurs it is considered - ANSWERNormal
Histologic changes occur in the terminal ducts and lobules with - ANSWERThe monthly hormone cycle
Cyclic changes where increased estrogen stimulates the proliferation of these normal structures and then
resorption occurs when estrogen levels drop
Fibrocystic disease leads to - ANSWEREnlarged lobules
Cysts
Stromal fibrosis
Ductal hyperplasia
Ductal ectasia/dilatation
,Women with moderate hyperplasia have - ANSWER1.5-2 times greater risk of developing breast cancer
Women with atypical ductal or lobular hyperplasia have - ANSWER3.5-5 times greater risk of developing
breast cancer
______ responsible for nearly 50% of all surgical procedures performed on the breast - ANSWERFibrocystic
disease
Mammo graphic appearance of fibrocystic disease - ANSWEREnlarged lobules lead to increased density of the
affected tissue
May see bilateral rounded water densities=multiple cysts
Sonographic appearance of fibrocystic disease - ANSWERAverage amount of subcutaneous fat with enlarged
lobules
Fibrous stromal areas appear brighter than parenchyma
Small cysts scattered throughout the br warn
Large cysts may also be present
Ductal dilatation(>3mm)
Benign breast proliferative disorder associated with fibrocystic disease - ANSWERPapillary Apocrine
Metaplasia (PAM)
Physiologic cause of visible change in TDLU size - ANSWERPapillary apocrine metaplasia
Pam can present as - ANSWERDiffuse enlargement of the lobules throughout the breast
,Pam can be associated with - ANSWERNipple discharge
Lack of dilated ducts and identifiable papilloma usually indicate nipple discharge related to PAM
When PAM occurs as a cystic structure - ANSWERLow level internal echoes within cyst
May have stringy or nodular appearance
Acorn cyst - ANSWERMural nodule or eccentrically thickened wall caused by PAM, cyst appears to have a cap
like and acorn
Position of PAM - ANSWERDoes not shift within the cyst with change in patient position
Cyst aspiration of PAM - ANSWERCyst will not be aspirated completely leaving the appearance of a mural
nodule
Mural nodules in a cyst are more commonly caused by? - ANSWERPAM than papilloma (benign or malignant)
PAM mural nodules appear - ANSWERUniformly hypoechoic, stringy and lacy
(While papilloma nodules are usually echogenic, heterogenous and coarse)
Papillomas usually connect to the cyst wall with a stalk or angular margin whereas PAM nodules have -
ANSWERA smooth connection along thin capsule of cyst
Papillomas usually demonstrate microlobulations of the inner wall while PAM nodules usually demonstrate -
ANSWERA smooth internal margin
PAM has - ANSWERNo blood flow
, Papilloma nodules have - ANSWERInternal flow
Most common breast lesion? - ANSWERSimple cyst
Most common cause of palpable lump? - ANSWERSimple cyst
Simple cysts are commonly seen in - ANSWERPremenopausal women
35-50yrs old
Simple cyst commonly associated with - ANSWERFibrocystic changes
Simple cysts can persist in postmenopausal women with - ANSWERHRT
Certain HTN medications and
Steroid therapy
Simple cysts may be - ANSWERSingle or multiple
Microcystic or macrocystic
Simple cyst originate - ANSWERIn the TDLU due to obstructed ductal outflow from the lobule
Clinical symptoms of simple cyst - ANSWERRecent lump and Recent tenderness that changes with menstrual
cycle; lump usually compressible and moveable
Mammographic appearance of simple cyst - ANSWERWater density
Round shake with smooth borders
