Courtney Mashburn

3/3/2015

Breast Assignment
Use the document entitled Advanced Breast Sonography available on the SDMS website 2011
Annual Conference Proceedings to help answer the following questions:

1. Label and identify the sonographic features of the following:

1
2
3
4

6
7
8

1.
2.
3.
4.
5.
6.
7.
8.

Coopers ligament
Skin
Subcutaneous fat
Pre-mammary fascia
Mammary zone
Retromammary fascia
Retromammary zone
Pectoralis

2. Explain the relationship among breast ducts, lactiferous ducts, lobes and lobules.
1. 15-20 lobes with varying number of ducts and lobules surrounded by connective
tissue. Each lobule has approximately 30 ductules.

Courtney Mashburn
3/3/2015

3. Explain at 3 scan techniques that can be used to evaluate the nipple.

1. Peripheral compression technique peripheral subareolar duct segment. Vigorous
compression on the peripheral end of the transducer and sliding it over the nipple to push the
nipple to the side, shadowing can be minimized, and the angle of incidence of the beam with
the subareolar ducts can be improved
2. Two handed compression technique central subareolar duct segment. Helps assess
the compressibility of the ducts. Can determine whether a lesion has penetrated through the
ductal wall.
3. Rolled nipple technique duct segment within nipple to orifice. Best way to
demonstrate the ducts within the nipple and if a lesion extends into the nipple from the
subareolar ducts.

4. Why would a patient present with nipple discharge?

1. Benign intraductal papilloma, carcinoma DCIS/invasive DCIS, PDH/ADH, duct ectasia,
communicating cyst, or idiopathic.

5. Why would it be important to identify an intraductal papillary mass?

1. To help determine if it is malignant or benign

For questions 6-10, find images that correlate with the following pathologies. Copy and paste
the images into this document - provide the url with the image.
6. Intraductal papilloma

Courtney Mashburn
3/3/2015

http://radiopaedia.org/articles/intraductal-papilloma-of-breast
7. Implant with a radial fold

http://www.ultrasoundpaedia.com/normal-breast/
8. Sebaceous cyst

Courtney Mashburn
3/3/2015

http://www.ultrasoundcases.info/Slide-View.aspx?cat=297&case=5137
9. Ruptured implant

http://www.ultrasoundcases.info/Slide-View.aspx?cat=317&case=7017
10. Normal and abnormal axillary lymph node

Courtney Mashburn
3/3/2015

http://www.ultrasoundcases.info/Slide-View.aspx?cat=315&case=3916

http://www.ultrasoundcases.info/Monthly-Case.aspx?month=218&show=1
For questions 11-20, use the resources found in your Breast Learning Module on Moodle as
reference tools:

Find images that correlate with the following pathologies. Copy and paste the
images into this document - provide the url with the image.
Identify one clinical finding associated with each pathology

11. Ductal carcinoma in situ

http://www.ultrasoundcases.info/Slide-View.aspx?cat=311&case=5334

One clinical finding would be bloody nipple discharge

12. Invasive ductal carcinoma

Courtney Mashburn
3/3/2015

http://radiopaedia.org/articles/invasive-ductal-carcinoma

One clinical finding would be a large palpable, immobile mass.

13. Lobular carcinoma

http://www.ultrasoundpaedia.com/pathology-breast/

One clinical finding would be thickening or hardening of the breast

14. Galactocele

Courtney Mashburn
3/3/2015

http://www.ultrasoundcases.info/Slide-View.aspx?cat=297&case=3472

One clinical finding would be painless breast lump in lactating women

15. Acorn Cyst

http://www.learningradiology.com/radsigns/radsignspages/A-radsigns.htm

One clinical finding would be palpable mass with pain or discomfort if large enough

16. Mastitis

Courtney Mashburn
3/3/2015

http://www.shmabstracts.com/abstract.asp?MeetingID=783&id=97991

One clinical finding would be breast tenderness, swelling, and redness

17. Fibroadenoma

http://www.ultrasoundpaedia.com/pathology-breast/

One clinical finding would be mobile palpable lump

18. Phyllodes

Courtney Mashburn
3/3/2015

http://www.ultrasoundpaedia.com/pathology-breast/

One clinical finding would be rapid growth of lump in women around the age of 45

19. Hamartoma

http://radiopaedia.org/images/4185112

One clinical finding would be painless soft lump

20. Fat Necrosis

Courtney Mashburn
3/3/2015

http://www.rad.washington.edu/academics/academicsections/mbi/education/mammoed/teaching-files/case-36/case-36-answer-2

One clinical finding would be a periareolar palpable lump