An inverting or shriveling of the

 breast tissue

May result from :

• degeneration of the breast
• cessation of lactation
• aging
• ovarian abiation

• rounded, oval, slight lobulation
• wider than tall
• smooth walls, no projections
• compressible
• mobile
• minimal blood flow
• displaces tissue planes, does not invade

• very common finding
• can result from an obstructed duct
• may be single or multiple, vary in size, and can occur in one or both breasts
• palpable, compressible
• pain or tenderness before menstruation

• any cyst that does not display round or oval shape, smooth contours, echo free, and posterior enhancement
• may display internal echoes or wall changes
• may be septated or have fluid/fluid level
• these cysts should be aspirated and sent to cytology, especially in cases of suspected infection or malignancy

• arises in the dermal layer of the skin
• result from obstruction of a sebaceous gland or hair follicle
• may need to use a stand-off pad
• could result in abscess formation
• may have internal echoes due to contents of cyst

• milk filled cyst
• appears during or shortly after lactation due to obstruction of a lactiferous duct
• should display low level echoes
• may be associated with mastitis or abscess formation

Fibrocystic changes

(FCC)

• Normal physiologic process
• Most common breast abnormality
• 40-50% of women
• affects women ages 30-50

• cyclic pain or tenderness
• diffuse or circumscribed areas of firmness
• focal lumpiness

• macrocysts
• microcysts
• cystic clusters
• ductal prominence
• course parenchymal pattern

• common, solid, and benign
• estrogen induced
• 15-35 yrs
• can grow during pregnancy, hormonal changes
• typically <3 cm, but may enlarge
• may decrease after menopause

technique used with color doppler to better visualize the borders of a solid mass

If sonographer turns on color and asks patient to "hum" the color should outline the borders of a solid mass

• results from epithelial proliferation within a duct. Ducts are lines with epi cells
• usually small
• mostly located behind the nipple or subareolar region
• clear, serous, or bloody nipple discharge

• made of adipose tissue
• compressible, oval shaped, circumscribed
• may be difficult to distinguish if large amount of fat exists in breast
• Isoechoic to parenchyma

• proliferation of fibrous and fatty tissues
• fibroadenolipoma
• encased in connective tissue
• encased in connective tissue
• oval, but may be lobulated
• heterogeneous echo texture
• compressible with probe pressure

• Bacteria can enter the breast via a cracked nipple or skin wound

• tender swollen breasts
• discharge
• skin thickening or reddening
• leukocytosis and possible fever

• edematous parenchyma
• dilated ducts
• increased echogenicity of fat
• hypervascularity of affected tissues

caused by a foreign body, TB, parasitis disease

not as commom

• hematomas and skin bruising

collection of serous fluid and plasma cells that can occur after surgery or trauma

most reabsorb

• male breast enlargement
• can be uni or bilateral
• associated with increased estrogen and decreased testosterone

Important characteristics:

• presence of echogenic central hilum in normal
• total absence of internal in the hilum of pathological
• normal has an oval appearance
• rounding is abnormal

• advanced age
• early menarche: late menopause
• nulliparity
• family history
• personal history of ovarian or endometrial CA
• estrogen use
• obesity

• spiculation
• taller than wide
• angular shadowing
• marked hypoechogenicity
• duct extension
• tissue invasion or disruption of tissue plane

This refers to lesions from one breast to another or from UIQ to LOQ of same breast.

Must be in different quadrants

most common type of breast cancer

75% of cases

infiltrating ductal carcinoma

IDC

Soft, sticky tumor has cancer cells suspended in mucinous material

Lacks clinical signs of cancers

Only about 2%

• Mimics fibroadenoma
• women under 35
• about 4-9% of cancers
• benign qualities

Indistinguishable from a benign papilloma

Intracycystic and intraductal forms

• Proliferative fibroadenoma
• usually benign by grow rapidly
• 30-50 years old
• 10% chance of malignanct transformation

Rare, occurs when a highly invasive carcinoma invades the lymphatics of the skin

Swelling, thickening, reddening of skin

Peau d' orange

• age
• exposure to radiation
• cryptorchidism
• family history

Most common reason for implant rupture

is what?

saline - echo free

silicone - contain low level echoes

rupture of the implant with silicone or saline remaining within the fibrous capsule formed by the body

"stepladder sign" correlates with "linguine sign" of MRI

Saline just leaks into the surrounding areas

Snowstorm sign - hyperechoic mass effect with loss of posterior wall

Performed for spontaneous nipple discharge

Needle with syringe & contrast material is inserted into leaking duct

Radioactive or "blue" dye is inserted and is watched to see the drainage of lymph, it identifies the sentinel node and removed

Fine needle aspiration

FNA

thin needle inserted into mass

Quick, short, ecisions are taken from multiple sites in the lesion