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who published the first paper on breast ultrasound and when?

John Wild in 1951

what is the location of the breast?

anterior to the pectoralis major and the 6th rib, bounded medially by the sternum and bordered laterally by the axilla

what is the anatomy of the surface of the breast?

nipple and areola

how does the breast appear sonographically?

divided into 3 layers between the skin and chest wall--subcutaneous, mammary, and retromammary layers

what is the subcutaneous layer?

skin and all subcutaneous fat

what is the mammary layer?

glandular tissues, ducts, and connective tissue

what is the retromammary layer?

retromammary fat, muscle, deep connective tissue

anatomically, what is the breast composed of?

parenchyma and stroma

what is the breast parenchyma?

lobes, lobules, ducts, and acini

what the breast stroma?

connective tissue and fat

what are the lobes of the breast?

normal breast is composed of 15 to 20 lobes separated by adipose tissue--each lobe has an external drainage pathway into the nipple

what are the breast lobules?

the lobes are divided into lobules which contain acini

what are the acini?

milk producing glands

what are coopers ligaments?

suspensory ligaments that support the breast tissue, which run between each lobe from the deep muscle fascia to the skin surface

what is the vascular supply to the breast?

lateral thoracic arteries supply the main supply to breast (axillary artery)--subclavian, and thoracic aorta

what are the breast lymphatics

lymphatic drainage from all parts of the breast generally flow to the axillary lymph nodes

what type of tissue is breast tissue?

its a modified sweat gland

what is the function of the breast?

lactation--milk secretion and ejection

what controls the production of milk?

hormones produced within the hypothalamus and anterior pituitary gland

what does the hypothalamus produce?

prolactin inhibiting factor

what hormone stimulates milk production?

prolactin

what gland produces prolactin?

the anterior pituitary

what triggers the production of prolactin?

after the placenta has been expelled and the estrogen levels have declined, prolactin levels increase

what besides prolactin triggers lactation?

oxytocin produced by the pituitary

what triggers the production of oxytocin?

stimulation from infants suckling triggers production of oxytocin and causes contraction of the lactiferous ducts and lactation begins

what is the milk pathway in the breast?

acini--terminal duct--terminal duct lobar unit--lobules--lobes, lactiferous duct, ampulla, nipple

what stimulates breast to form in puberty?

estrogen from the ovaries before menses

what hormone triggers the breast to develop into its mature lobulated form?

progesterone influences formation of lobules

how do the breasts change during the monthly cycle?

they enlarge slightly during menstrual cycle due to water retention

what are breasts mainly composed of?

fibroglandular tissue

how does breast tissue change during pregnancy?

proliferation of ductal system and lobules

what are the changes that happen to the breast during menopause?

glandular tissue atrophies and breast becomes mainly composed of fatty tissue and ducts become ectatic

what is the % of fat to age after menopause?

age 50--40% fat, age 60--50% fat, age 80--100% fat

how does HRT affect natural aging process of breasts?

it delays involution of breast tissue

what are the three steps for routine breast cancer screening?

monthly self exam, regular clinical breast exams, screening mammography

what are the two main indications for breast us?

diagnostic and interventional imaging

what are some of the methods for describing breast lesion location?

4 quadrants UI, UO, LI, LO----clock face radial: 3, 6, 9 oclock etc-----123 method of 1 near the nipple, 2 mid circle around, 3 outer circle around nipple----ABC method with A closest to nipple, B mid, C closest to chest wall

what position is CC in mammo

superior to inferior compression of the breast--equal to trv scan plane

where is the marker in a CC mammo?

at the lateral border of the breast of interest

how is lesion position described in a CC mammo?

as lateral or medial to the nipple

what is MLO in mammo?

medial to lateral compression of breast tissue from 30 to 60 degree oblique

how is the lesion location described in MLO mammo?

as superior or inferior to nipple

lesions found to be medial in CC mammo will appear____on MLO

slightly lower

lesions found to be lateral on CC view will appear____in MLO

slightly higher

what is MULD?

medial up, lateral down

lesions found in mammo must be: c

correlated in size, shape, density, position, and appearance in sonography

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