Breast Lesions Characteristics Quiz

Breast Pathology

• Obscured margins indicate invasive growth into surrounding tissue, making it difficult to distinguish lesion edges from normal tissue.
• Asymmetric density occurs when one breast has a different size, volume, position, or form from the other, often evaluated using one projection.
• Focal asymmetry is a lesion seen on two mammographic views (CC and MLO) with concave borders, lacking features of a true mass, and requires further sonographic evaluation and potentially percutaneous sampling.
• Calcifications are deposits of calcium salts in the breast, radiopaque on mammography, often normal metabolic occurrences, and usually benign.

Breast Abnormalities

• Polythelia is the presence of supernumerary nipples or nipple-areolar complexes, occurring anywhere along the mammary ridge, and is treated with simple excision.
• Polymastia is common in the axilla and can be associated with polythelia, treated with excision or liposuction.
• Amastia and athelia result from the failure of mammary ridges to develop or completely disappear, a rare clinical anomaly.
• Poland syndrome is a disorder characterized by missing or underdeveloped muscles on one side of the body, affecting the chest, shoulder, arm, and hand.

Nipple and Breast Changes

• Inverted nipple is a normal variant but may represent malignancy or infection, and can be corrected for cosmetic purposes, potentially leading to the inability to breastfeed.
• Virginal or juvenile breast hypertrophy is a rare condition with extremely rapid breast growth during puberty.
• Tuberous breasts are a congenital anomaly of breast shape, characterized by a constricted base and herniation of breast tissue under an enlarged areola.
• Breast asymmetry occurs when one breast has a different size, volume, position, or form from the other, and can be a sign of cancer.

Skin and Breast Changes

• Skin irritation can cause a red/reddish-brown rash or irritated skin under the breasts, leading to raw, open areas with oozing, cracked, or crusty skin, and potentially a bacterial or fungal infection.
• Pain can include breast tenderness, sharp burning pain, or tightness in the breast tissue, and may be constant or occasional.
• Discharge can be caused by various factors, including abscess, breast cancer, breast infection, ductal carcinoma in situ (DCIS), endocrine disorders, and others.

Other Conditions

• Gynecomastia is an increase in male breast tissue, often caused by an imbalance in estrogen/androgen ratios, and may be secondary to medications, street drugs, herbal products, or medical conditions.
• Breast reduction surgery is an operation to remove extra fat, tissue, and skin from the breasts.
• Edema appears as thickened skin with enlarged pores (peau d'orange sign), often seen in the lower portion of the breast or areola.
• Nipple retraction occurs when the nipple turns inward instead of outward, except when stimulated.

Clinical Breast Changes

• Lumps are localized swelling, protuberance, bulge, or bump in the breast that feels different from the surrounding tissue, and may be caused by infection, trauma, fibroadenoma, cyst, fat necrosis, or fibrocystic breasts.
• Swelling occurs due to hormonal changes, causing breasts to feel heavy, achy, and tender.
• Dimpling is a common sign of inflammatory breast cancer, drawing its name from an inflamed appearance.

Diagnostic Procedures

• Surgical biopsy involves removing a sample of tissue from a suspicious area in the breast for further examination, and is considered the gold standard for diagnosing breast cancer.
• Wire localization biopsy involves inserting a thin wire into the breast to mark the precise location of the abnormality before surgical removal.
• Genetic testing may be recommended for individuals with a family history of breast cancer or certain genetic mutations associated with an increased risk of the disease.