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Solid Benign Breast Lesions Flashcards

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1
Q

What are the 6 basic types of benign solid breast pathologies?

A
  1. Fibroadenoma
  2. Phyllodes tumour
  3. Focal dysplastic papillomatosis
  4. Nipple adenoma
  5. Benign soft tissue breast tumours
  6. Benign skin tumours
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2
Q

What is the most common benign solid lesion found in women under age 35?

A

Fibroadenoma

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3
Q

FA

A

Fibroadenoma

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4
Q

What is the age range for FAs?

A

15-35

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5
Q

What % of all women have FAs?

A

10%

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6
Q

What % of African-American women have FAs?

A

20%

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7
Q

When can you see FAs in menuopausal women?

A

When they are HRT

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8
Q

What % of FA make up all benign breast pathology?

A

50%

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9
Q

What type of women are more likely to get FAs?

A

African American Women

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10
Q

What does an FA feel like clinically? (4)

A
  1. Firm
  2. Mobile
  3. Elliptical shape
  4. Elastic rubbery consistency
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11
Q

How fast do FAs normally grow? What the exception?

A
  1. Slow growing
  2. Pregnancy
    - due to influx of hormones
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12
Q

What 2 elements make up an FA?

A
  1. Epithelial tissue
  2. Connective tissue
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13
Q

What kind of patterns do FAs protray?

A

Popcorn

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14
Q

What are 6 characteristics of an FA?

A
  1. Hypoechoic
  2. Homogenous
  3. Well circumscribed
  4. Round/oval
  5. Thin echogenic capsule
  6. Posterior enhancement
    - sometimes
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15
Q

What makes an FA complex?

A

When septations and calcifications are demonstrated

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16
Q

How big should an FA be before having a Bx done in it?

A

4cm

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17
Q

If an FA were to have some vascularity to it, where is it typically located?

A

On the periphery

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18
Q

What age range do juvenile FAs occur in?

A

10-18
- very young, adolescent women

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19
Q

How are juvenile FAs typically diagnosed?

A

Clinically

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20
Q

What is the growing pattern for juvenile FAs?

A

Extremely fast growing

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21
Q

How do juvenile FAs typically present?

A

With a very large mass that scratches the overlying skin
- often displacing the nipple

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22
Q

What are characteristics seen on US of a juvenile FA? (5)

A
  1. Round
  2. Solid mass
  3. Well defined borders
  4. Some posterior enhancement
  5. Shadowing from lateral borders
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23
Q

What is a papilloma composed of? (2)

A
  1. Lining cells of a lactiferous duct
  2. Underlying stroma, supportive tissues
    - including blood vessels
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24
Q

What do papilloma often cause? (2)

A
  1. Bleed
  2. Secrete fluid
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25
What do Pts with a papilloma often present with?
Spontaneous nipple discharge
26
What is the most common cause of bloody nipple discharge?
Papilloma
27
Where do papillomas originate from?
Within a lactiferous duct
28
Can you typically palpate a papilloma?
No
29
What do papillomas do to the ducts?
Dilate them
30
What happens if you apply pressure to a papilloma?
Elicit the discharge - eg. trigger point
31
Where are papillomas often located?
Subareolar region
32
What are not commonly picked up on mammo? What is the better imaging method?
1. Papilloma 2. Ductogram
33
What are 5 characteristics of a papilloma on US?
1. Small 2. Round/oval 3. Well defined 4. Homogenous 5. Hypoechoic
34
What are most papillomas connected with?
Vascular stalk
35
How fast do papillomas grow?
Slow growing - non-invasive
36
Are papillomas malignant?
No - but over time they could become (rare)
37
What age group do you see Pts with juvenile papillomas?
19-23 - adolescent or young girls
38
Up to 50% of patients with juvenile papillomatosis have, what?
First degree relative with a history of breast cancer
39
How do juvenile papillomas present as? (2)
1. Painless 2. Solitary and unilateral mass
40
Where do juvenile papillomas arise from?
Within the milk duct
41
How large can juvenile papillomas typically get?
4cm
42
What do juvenile papillomas typically present with?
Nipple discharge
43
What are 3 characteristics of juvenile papillomas?
1. Well circumscribed 2. Heterogenous 3. One or several small rounded relatively echo-free cystic areas seen mainly or exclusively near the borders of the lesion
44
What kind of appearance do juvenile papilloma have?
Swiss cheese - multiple small cysts interspersed with dense stroma
45
When can phyllodes tumour become malignant?
When they exceed 3cm - 10% of cases
46
What % of phyllodes tumour make up all breasts lesions?
0.3-1.0%
47
What is another term for phyllodes tumour?
Cystosarcoma Phyllodes
48
What does Phyllodes mean in latin?
Leaf
49
What does a phyllodes tumour have?
Leaf like processes that project into cystic spaces within the tumour
50
What are 2 risk factors for phyllodes tumours becoming malignant?
1. Cystic spaces over 3cm 2. Over 45 years
51
What are 3 characteristics of a phyllodes tumours on US?
1. Hypoechoic 2. Well circumscribed 3. Oval mass
52
What is the most common breast sarcoma?
Phyllodes tumour
53
How fast do phyllodes tumours grow?
It's a rapidly enlarging breast mass
54
What is the average age of getting a phyllodes tumour?
45
55
In what type of Pt is a lactating adenoma commonly found?
Pregnant or nursing women
56
What are 7 characteristics of a lactating adenoma?
1. Large 2. Oval 3. Well defined 4. Mobile 5. Macrolobulated masses 6. Has fibrotic septae - eg. echogenic bands within mass 7. Usually demonstrate posterior enhancement
57
When do lactating adenomas appear? Regress?
1. When one is lactating 2. After lactation
58
What typically occurs at site when lactation stops?
Redness
59
What are tubular adenoma composed of?
Proliferating tubules with little intervening stroma
60
What are 6 characteristics of a tubular adenoma?
1. Mobile 2. Oval 3. Homogenous 4. Hypoechoic 5. Well circumscribed 6. Little through enhancement
61
What is a defining feature of a tubular adenoma?
Tightly packed, punctate calcifications scattered throughout the mass
62
What is the most common benign soft tissue tumour found in the body?
Lipoma
63
How fast do lipomas grow?
Slow growing
64
What is lipomas composed of?
Fatty tissue that form a smooth or slightly lobulated mass enclosed by a thin, fibrous capsule
65
What are 5 characteristics of a lipoma? (not on US)
1. Unilateral 2. Palpable 3. Mobile 4. Soft 5. Asymptomatic
66
Where are lipomas located? (3)
1. Premammary 2. Retromammary layer 3. Within the axilla
67
What are lipomas often confused with?
Lymph nodes
68
What are lipomas more compressible than?
FA
69
What are 2 other names for hamartoma?
1. Fibroadenolipoma 2. Adenofibrolipoma
70
How is a hamartoma described as?
Breast within a breast
71
How fast do hamartomas grow?
Slow groing
72
What are 3 characteristics of a hamartoma?
1. Oval 2. Mobile 3. Compressible
73
What age range do hamartomas typically deveople?
40-50
74
What are hamartomas composed of? (4)
1. Fibrous tissue 2. Fatty tissue 3. Normal mammary tissue 4. Dysplastic mammary tissue
75
How do hamartomas appears on US?
1. Mixed echotexture 2. Hyperechoic tissue surrounding hypoechoic areas - because of the fat and fluid that make up the mass
76
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