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?
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?
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
lesions found to be lateral on CC view will appear____in MLO
what is MULD?
medial up, lateral down
lesions found in mammo must be: c
correlated in size, shape, density, position, and appearance in sonography