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Breast
front 1 How many women will develop breast cancer? | back 1 1 in 8 |
front 2 True or False? Breast cancer is the leading cause of death in middle aged women | back 2 True |
front 3 When should a breast scan be performed? | back 3 a mass is located by palpation or mammography |
front 4 What is the primary reason for breast sonography? | back 4 differentiate between simple cysts complex cysts solid masses |
front 5 Why is breast sonography at a disadvantage on young women? | back 5 less fat and more parenchyma. |
front 6 what type of machines are used on breast exams? | back 6 state of art less than 5 years |
front 7 What type of transducer should be used on breast exams? | back 7 7 MHz - 12 MHz linear |
front 8 What should you do if you find a mass larger than the footprint of the transducer? | back 8 change to a curvilinear |
front 9 What is said about the sonographer of breast exams? | back 9 breast exams are operator dependent and so should be experienced |
front 10 True or False? Multiple focuses give better resolution. | back 10 true but temporal resolution takes a hit |
front 11 Where is the retromammary layer located? | back 11 in the pectoralis muscles |
front 12 Where are the acini cells? | back 12 within the lobules |
front 13 What are acini cells? | back 13 milk producing cells |
front 14 lobules + lobules + lobules = | back 14 lobe |
front 15 where are lymphatic vessels in the breast? | back 15 run from the acini cells to the nipple |
front 16 What are ducts made up of? | back 16 basement membrane and a ductal epithelium |
front 17 True or False? Ductal epithelium are contractile. | back 17 True |
front 18 Why does dynamic range improve imaging? | back 18 by adding more shades of gray and may demonstrate subtle tissue differences |
front 19 Why are neither color or power Doppler reliable in distinguishing benign from malignant lesions? | back 19 both may demonstrate internal flow |
front 20 Why is Doppler helpful during a breast exam? | back 20 distinguishing solid vs cystic - flow confirms a solid inflamed vs noninflamed - increased flow complex cyst vs intraductal papilloma |
front 21 True or False? Doppler can positively confirm solid vs cystic lesions | back 21 False flow confirms a solid flow does NOT confirm cystic |
front 22 Explain the sonographic appearance of cysts. | back 22 anechoic and circular thin walls through transmission |
front 23 What is the superficial fascia? | back 23 triangular bag that contains the contents of the breast contained within the subcutaneous layer anterior to the mammary layer |
front 24 Breast anterior to posterior | back 24 skin subcutaneous layer mammary layer retromammary space muscle layer chest wall |
front 25 How thick is the skin on the breast? | back 25 .5 - 2 mm |
front 26 How many lactiferous ducts openings in the nipple? | back 26 15-20 |
front 27 What does the nipple consist of? | back 27 nerve endings & lactiferous ducts |
front 28 What is the areola? | back 28 area of dark pigmentation |
front 29 What are Montgomery's glands | back 29 small bumps |
front 30 What does the subcutaneous layer primarily consist of? | back 30 fat |
front 31 True or False? Breast fat increases with age | back 31 True |
front 32 Does the Fat extend behind the nipple? | back 32 NO |
front 33 Explain the sonographic appearance of the subcutaneous layer of the breast. | back 33 multiple homegenous midlevel gray lobule structures separated by brightly echogenic ligaments |
front 34 Where are the cooper's ligaments? | back 34 runs between superficial to deep layers extends from the clavicle and the pectoralis muscles to the skin |
front 35 What is the sonographic appearance of Cooper's ligaments? | back 35 thin brightly echogenic membranes separating fat lobules |
front 36 What is the purpose of Cooper's ligaments? | back 36 provide skeletal framework of the breast |
front 37 Why can Cooper's ligaments be a pitfall? | back 37 may cause acoustic shadowing |
front 38 What is another name for the Mammary layer? | back 38 parenchymal Glandular layer |
front 39 What is the Tail of Spence? | back 39 portion of the glandular tissue that extends into the axilla |
front 40 What does the mammary layer consist of? | back 40 stoma epithelium |
front 41 What is breast stroma? | back 41 supportive tissue in the mammary layer |
front 42 What does the stroma consist of? | back 42 interlobular fat loose and dense connective tissue cooper's ligaments |
front 43 What is Breast Epithelium? | back 43 Functional tissue of the breast |
front 44 What does breast epithelium consist of? | back 44 acini terminal Duct Lobular units TDLU Lobules Lobes Lactiferous ducts |
front 45 What are the smallest functional unit in the breast? | back 45 acini cells |
front 46 How many acini cells in each breast? | back 46 hundreds |
front 47 How many acini cells in each TDLU? | back 47 30 |
front 48 True or False? Each acini gives rise to a terminal duct. | back 48 true |
front 49 What is the order of the breast? | back 49 Acini (30) TDLU (lots) Lobules (10-15) Lobes (15-20) Breast |
front 50 What is a TDLU | back 50 terminal Duct Lobular units |
front 51 What is the usual measurement for the TDLU? | back 51 2 mm or less |
front 52 Where does almost all breast pathology originate? | back 52 TDLU |
front 53 How many acini and terminal ducts form a lobule? | back 53 30 |
front 54 How many lobules make up a lobe | back 54 10-15 |
front 55 How many lobes in a breast? | back 55 15 to 20 |
front 56 What emerges from each from lobe and travels toward the nipple? | back 56 lactiferous duct |
front 57 What carries milk? | back 57 lactiferous duct acini to nipple |
front 58 What are the lactiferous ducts called arising from the acini? | back 58 terminal ducts |
front 59 What are the lactiferous ducts called in the lobules? | back 59 intralobular |
front 60 What are the lactiferous ducts called in the lobes? | back 60 extralobular |
front 61 What are the lactiferous ducts beneath the areola? | back 61 lactiferous sinus |
front 62 What are the two muscles of the breast? | back 62 pectoralis major pectoralis minor |
front 63 Where does the pectoralis minor arise? | back 63 3rd, 4th and 5th ribs |
front 64 Where does the pectoralis major arise? | back 64 clavicle and costal cartilage of the sternum |
front 65 Which muscle is anterior? | back 65 pectoralis major |
front 66 What causes breast development? | back 66 hormonal stimulation by the ovaries |
front 67 What does Estrogen stimulate in the breast? | back 67 elongation increase in connective tissue adipose tissue vascularity |
front 68 What does progesterone stimulate in the breast? | back 68 growth of TDLU |
front 69 What are the menstrual Breast changes during days 1-5? | back 69 decrease in size |
front 70 What are the menstrual Breast changes during days 6-9? | back 70 Menstrual post |
front 71 What are the menstrual Breast changes during days 6-13? | back 71 proliferated or production of acini cells TDLU |
front 72 What are the menstrual Breast changes during days 13-28? | back 72 Secretory - ducts enlarge edematous |
front 73 What happens to the breast in the early stage of pregnancy? | back 73 lactiferous ducts increase in size |
front 74 What happens to the breast in the late stage of pregnancy? | back 74 stroma is crowded and displaced |
front 75 What stimulates the production of milk? | back 75 prolactin dominates after birth and acini cells secrete milk |
front 76 When do ducts and lobules return to their normal size after pregnancy? | back 76 3 months after termination of breast feeding |
front 77 What happens to the breast during menopause? | back 77 Shrivel and roll forward loose - dense dense - stoma strom - fat |
front 78 What two main arteries supply the breast? | back 78 Lateral Thoracic Internal Mammary |
front 79 Where does the Lateral Thoracic Artery arise from? | back 79 the axillary artery |
front 80 Where does the Internal Mammary Artery arise from? | back 80 subclavian artery |
front 81 What are the secondary arterial supplies of the breast? | back 81 Thoracoacromial artery intercostal artery |
front 82 What artery is used for the CABG procedure? | back 82  Internal Mammary |
front 83 What veins drain the breast? | back 83 Internal Mammary Vein Axillary Vein Subclavian Vein Intercostal Veins |
front 84 How does breast cancer most frequently spread? | back 84 blood flow routes |
front 85 What vein is commonly blamed for breast cancer metastasis to ribs? | back 85 Intercostal Veins - communicates with vertebral veins |
front 86 What is the most common metastasis of Breast Cancer? | back 86 bone lung liver |
front 87 Why is the axillary lymph node chain important in predicting the spread of breast cancer? | back 87 75% of lymphatic drainage is the the axilla |
front 88 How do you identify the sentinel lymph node | back 88 A surgeon injects a radioactive substance, a blue dye, or both near the tumor to locate the position of the sentinel lymph node. The surgeon then uses a device that detects radioactivity to find the sentinel node or looks for lymph nodes that are stained with the blue dye. |
front 89 Why is the sentinel lymph node important? | back 89 if the sentinel lymph node is clear then the rest will be clear. |
front 90 Explain the Lymphatic drainage of the breast. | back 90 Most lymphatics of the breast first drain superficially to the anterior mammary fascia. Then to the periareolar plexus and the axilla |
front 91 What is the most common cancer to metastasize to the breast? | back 91 Melanoma |
front 92 True or False? Metastatic disease of the breast from another primary cancer is uncommon. | back 92 True |
front 93 What is the pancake view? | back 93 medio-lateral oblique |
front 94 What is the omelet view? | back 94 cranio-caudal |
front 95 What is a stand-off pad | back 95 allows for greater detail in the superficial layers of the breast |
front 96 What is the ideal thickness of a stand-off pad? | back 96 1 cm |
front 97 What would you explain to the patient about a breast exam? | back 97 The sonographer should explain to the patient that the exam is being performed to visualize the breast and to investigate mammogram findings |
front 98 How should a patient dress for a breast exam? | back 98 The patient should undress from the waist up and wear a hospital gown open in the front. |
front 99 What transducer should be used on a breast exam? | back 99 7 – 12 MHz linear array transducer |
front 100 What do you do if the mass is larger than the footprint? | back 100 change to a curvilinear probe. |
front 101 What positions should be used for a breast exam? | back 101 Supine Supine oblique may be used for the lateral margin of the breast |
front 102 What are the scan planes for a breast exam? | back 102 radial and anti-radial, sagittal and Transverse Radial plane – runs parallel to the ducts, the transducer is held at a radial plane with the nipple in the center. Anti-radial plane – runs perpendicular to the ducts |
front 103 What is a radial & anti-radial scan plane? | back 103 radial - runs parallel to the ducts, the transducer is held at a radial plane with the nipple in the center. Anti-radial plane – runs perpendicular to the ducts |
front 104 What techniques can be used during a breast exam? | back 104 Fremitus: Have the patient hum with power Doppler, everything lights up except for mass Ipsilateral arm is raised above the head -- provides a more stable scanning surface Stand-off pad to visualize superficial structures Gentle but firm pressure - forces tissues into a parallel plane |
front 105 Describe the anatomy of the breast. | back 105 The breast lies anterior to the 6th rib and pectoralis muscles. Breast tissue is supported by cooper’s ligaments that extend from deep muscle fascia to the skin. The breast is described in layers. |
front 106 What does the Subcutaneous Layer consist of? | back 106 Consists of skin and adipose tissue. |
front 107 What does the Mammary Layer consist of? | back 107 Consists of 15 to 20 lobes containing glandular tissue, ducts, fat lobules and connective tissue. |
front 108 What does the Retromammary Layer consist of? | back 108 Consists of fat lobules, connective tissue and muscle. |
front 109 What are appropriate reasons for the breast exam? | back 109 Mass found by palpitation Mass found by mammogram Differentiate
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front 110 What are appropriate History Questions for a breast exam? | back 110 When was the last time you had menstrual Period? Are you in pain? Where is your pain located? How long have you been in pain? How long does the pain last and does it go away? Are you experiencing any other symptoms? Do you have a family history of breast cancer? Have you had any lab work done? |
front 111 What are the required images in a breast exam? | back 111 Document the lesion in at least two planes.
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front 112 What is the sonographic appearance of the Subcutaneous Layer? | back 112 Most superficial layer, The skin appears as a hyperechoic border. Inferior to the skin is the subcutaneous fat lobules which appear as low-level echoes with hyperechoic margins |
front 113 What is the sonographic appearance of the Mammary Layer? | back 113 Mix between fat and glandular tissue, Depending on the fat content the parenchyma can appear highly echogenic with little fat or areas of low echogenicity mixed with areas of high echogenicity. |
front 114 What is the sonographic appearance of the Retromammary Layer? | back 114 Generally hypoechoic relative to the mammary layer. Inferior to the breast the pectoralis muscle can be seen as a hypoechoic area. . |
front 115 What is the sonographic appearance of breasts in young patients? | back 115 Young patients have little fat and dense breasts will appear highly echogenic. |
front 116 What is the sonographic appearance of breasts in child-bearing age patients? | back 116 Women of child-bearing age have an increase in fibrous tissue and dense connective tissue which will cause the breast to be highly echogenic. |
front 117 What is the sonographic appearance of breasts in post-menopausal patients? | back 117 As the patient ages the glandular tissue shrinks. The breast appears hypoechoic |
front 118 What are normal variants of breasts? | back 118 Amastia Polymastia Athelia Amazia Unilateral early ripening Nipple inversion |
front 119 What is Amastia? | back 119 complete absence of one or both breasts |
front 120 What is Polymastia ? | back 120 an accessory breast |
front 121 What is Athelia ? | back 121 an accessory nipple |
front 122 What is Amazia ? | back 122 nipple but no breast tissue |
front 123 What are the measurements for a breast exam? | back 123 Simple cyst: record at least greatest dimensions Solid lesions: record all 3 dimensions Multiple lesions: record largest and smallest Ducts: 2-3 mm |
front 124 What are benign conditions? | back 124 noncancerous disorders that can affect the breast Sonographic Appearance: Round, oval Wider than tall Thin walls Anechoic, hyperechoic, homogenous Posterior enhancement Edge shadowing Calcifications Along Fibrous planes Ducts measure 2-3 mm Doppler – no flow Presentation: breast lump, redness, pain, tenderness swelling, multiple cysts, palpable superficial, spherical nodule, discharge, nipple retraction , feeling of fullness, subareolar thickenin |
front 125 What is the Sonographic Appearance of benign breast lesions? | back 125 Round, oval Wider than tall Thin walls Anechoic, hyperechoic, homogenous Posterior enhancement Ducts measure 2-3 mm Doppler – no flow |
front 126 What are the presentations of women with benign breast conditions? | back 126 breast lump redness pain tenderness swelling multiple cysts palpable superficial spherical nodule discharge nipple retraction feeling of fullness subareolar thickening |
front 127 What are Malignant conditions? | back 127 cancerous disorders that can affect the breast |
front 128 What is the Sonographic Appearance of malignant breast lesions? | back 128 Taller than wide Angular, ill-defined, microlobulations Thick borders Echogenic halo Almost anechoic, heterogenous Shadowing Color Doppler - more peripheral and internal flow Invade tissue planes |
front 129 What is a simple cyst? | back 129 benign breast condition Very common in women ages 35 to 50 Results from obstructed duct or hormonal changes Regress after menopause Presentation: breast lump, pain & tenderness |
front 130 What is the Sonographic Appearance of simple cysts? | back 130  Oval or round anechoic smooth walls well circumscribed shape posterior enhancement edge refraction sharp anterior and posterior borders reverberation |
front 131 What is a Complex Cysts? | back 131 benign breast condition contain some low level internal echotexture or intra-cystic debris. Risk of malignancy among complicated breast cysts is thought to be 0.3-2% |
front 132 What is the Sonographic Appearance of Complex Cysts? | back 132 Low to medium echogenicity Irregular walls hetertogenous fluid filled levels septations wall thickening debris varying degrees of shadowing |
front 133 What are the presentations of Complex Cysts? | back 133 breast lump |
front 134 What is Galactocele? | back 134 benign breast condition Milk filled cyst, results from obstructed duct after childbirth |
front 135 What is the Sonographic Appearance of Galactocele? | back 135  Round Hyperechoic Homeogenous |
front 136 What are the presentations of Galactocele? | back 136 breast lump |
front 137 What is a Sebaceous Cyst? | back 137 benign breast condition Superficial, sebum containing, results from obstructed sebaceous gland |
front 138 What is the Sonographic Appearance of Sebaceous Cyst? | back 138  Small Hypoechoic Close to the skin surface Through transmission No detectable vascular flow Hypo- and hyperechoic alternating rings A characteristic track may be seen extending into the skin surface |
front 139 What are the presentations of Sebaceous Cyst? | back 139 breast lump |
front 140 What is Fibrocystic Condition? | back 140 benign breast condition Produce tissue alterations in both epithelial and connective tissue. Fluctuates with normal hormonal cycles |
front 141 What is the Sonographic Appearance of Fibrocystic Condition? | back 141  Multiple cysts Well circumscribed thins walls Increased fibrous stroma |
front 142 What are the presentations of Fibrocystic Condition? | back 142 multiple cysts, pain & tenderness. |
front 143 What is Fibroadenoma? | back 143 benign breast condition Estrogen related tumor. Most common benign solid tumor of the breast. Primarily in young women |
front 144 What is the Sonographic Appearance of Fibroadenoma? | back 144  Oval Gently lobulated Hyperechoic Uniform echogenicity Smooth distinct borders Wider than tall Enhancement Edge shadowing Arise from TDLU Pseudo-encapsulated |
front 145 What are the presentations of Fibroadenoma? | back 145 Painless palpable mass, firm rubbery |
front 146 What is Lipoma? | back 146 benign breast condition Encapsulated tumor of mature adipose tissue. |
front 147 What is the Sonographic Appearance of Lipoma? | back 147  Well-defined Oval Thin smooth walls Homeogenous hyperechoic Isoechoic with fat Enhancement Edge shadowing no calcification |
front 148 What are the presentations of Lipoma? | back 148 Asymptomatic, painless palpable breast lump which is soft and mobile |
front 149 What is Fat Necrosis? | back 149 benign breast condition May be caused by trauma to the breast or other disease present |
front 150 What is the Sonographic Appearance of Fat Necrosis? | back 150  Irregular complex mass Low-level echoes Edge shadowing Separate from breast parenchyma Mimic malignant tumor |
front 151 What are the presentations of Fat Necrosis? | back 151 palpable superficial, spherical nodule |
front 152 What is Acute Mastitis? | back 152 benign breast condition Inflammation of the breast, lactational is most common. Antibiotics |
front 153 What is the Sonographic Appearance of Acute Mastitis? | back 153  Blurred tissue planes Skin thickening Ductal dilation Increased color flow |
front 154 What are the presentations of Acute Mastitis? | back 154 localized or whole breast, Redness, pain and swelling |
front 155 What is Chronic Mastitis? | back 155 benign breast condition Inflammation of the glandular tissue, usually found in older women |
front 156 What is the Sonographic Appearance of Chronic Mastitis? | back 156  Difficult to differentiate by ultrasound Diffused echo patterns Thickening of connective tissue |
front 157 What are the presentations of Chronic Mastitis? | back 157 discharge, nipple retraction, subareolar thickening |
front 158 What is Abscess? | back 158 benign breast condition complication of mastitis, usually in subareolar region |
front 159 What is the Sonographic Appearance of Abscess? | back 159  hyperechoic Complex Irregular borders Posterior enhancement Skin thickening Increased color flow |
front 160 What are the presentations of Abscess? | back 160 painful lump, swelling, nipple discharge |
front 161 What is Gynecomastia? | back 161 benign breast condition Enlargement of the male breast Causes include – hormonal changes, testicular failure, neoplasm, marijuana, klinefelters (XXY) Lab Values: ↑Estrogen, ↓Testosterone |
front 162 What is the Sonographic Appearance of Gynecomastia? | back 162  nodular pattern dendritic pattern diffuse glandular pattern |
front 163 What is Cystosarcoma? | back 163 benign breast condition A rare disease mostly benign breast neoplasm |
front 164 What is the Sonographic Appearance of Cystosarcoma? | back 164  Large Hypoechoic tumor Well-defined Decreased through transmission Fine or course internal echoes Variable amounts of shadowing |
front 165 What are the presentations of Cystosarcoma? | back 165 small breast mass that suddenly enlarges |
front 166 What is Intraductal Papilloma? | back 166 benign breast condition Benign tumor originating from the ductal epithelium and projecting into the lumen of the duct. Commonly in women ages 35 to 55. |
front 167 What is the Sonographic Appearance of Intraductal Papilloma? | back 167  Less than 2 mm Subareolar region broad-based pedunculated fibrovascular stalk |
front 168 What are the presentations of Intraductal Papilloma? | back 168 bloody discharge, feeling of fullness or pain in the areola |
front 169 What is Ductal Carcinoma in Situ (DSIS)? | back 169 malignant breast condition Most common non-invasive breast cancer. Arises from the TDLU, malignant changes of the ductal epithelium without extension past basement membrane. Excellent cure rate |
front 170 What is the Sonographic Appearance of Ductal Carcinoma in Situ (DSIS)? | back 170  Calcifications Ductal enlargements Extensions within the ducts |
front 171 What is Invasive Ductal Carcinoma (IDC)? | back 171 malignant breast condition 80% of Breast cancer. Begin in the duct and invade the fatty tissue. Potential for metastases |
front 172 What is the Sonographic Appearance of Invasive Ductal Carcinoma (IDC)? | back 172  Calcifications Ductal enlargements Invasion of the breast parenchyma |
front 173 What is Lobular Carcinoma in Situ(LCIS)? | back 173 malignant breast condition precancerous, considered lobular neoplasm. |
front 174 What is the Sonographic Appearance of Lobular Carcinoma in Situ(LCIS)? | back 174  Confined to the gland Difficult to distinguish with sonograms |
front 175 What is Invasive Lobular Carcinoma (ILC)? | back 175 malignant breast condition 10 to 15% of breast cancer, begins in the duct and invades the fatty tissue. Potential for metastases. |
front 176 What is the Sonographic Appearance of Invasive Lobular Carcinoma (ILC)? | back 176  Begins in the lobule Extends into fatty tissue Bilateral Multicentric multifocal |
front 177 What is Comedocarcinoma? | back 177 malignant breast condition Intraductal solid carcinoma ducts filled with yellow paste-like that resembles a plug. |
front 178 What is the Sonographic Appearance of Comedocarcinoma? | back 178 Microcalcifications Irregular borders Diffuse internal echoes shadowing |
front 179 What are the presentations of Comedocarcinoma? | back 179 pain, sensation of insects crawling, nipple retraction, dominant mass, clear discharge |
front 180 What is Juvenile Breast Cancer? | back 180 malignant breast condition Similar to DCIS & IDC found in girls 8 to 15. |
front 181 What is the Sonographic Appearance of Juvenile Breast Cancer? | back 181  Calcifications Ductal enlargements Extensions within the ducts |
front 182 What is Papillary Carcinoma? | back 182 malignant breast condition Tumor that arises as an intraductal mass. 1% – 2% of Breast Cancer |
front 183 What is the Sonographic Appearance of Papillary Carcinoma? | back 183  Hypoechoic solid mass Posterior enhancement Complex cystic and solid masses may be evident. Relatively vascular |
front 184 What are the presentations of Papillary Carcinoma? | back 184 bloody discharge, palpable mass |
front 185 What is Paget’s Disease? | back 185 malignant breast condition Rare tumor, arises in the retroareolar duct and grows toward the nipple. Women over 50 |
front 186 What is the Sonographic Appearance of Paget’s Disease? | back 186  Retroareolar Mass Irregular borders Hetergenous internal echoes Posterior enhancement |
front 187 What are the presentations of Paget’s Disease? | back 187 rash—like appearance |
front 188 What is Scirrhous Carcinoma? | back 188 malignant breast condition intraductal tumor with extensive fibrous tissue. |
front 189 What is the Sonographic Appearance of Scirrhous Carcinoma? | back 189 Focal calcifications Dense fibrous |
front 190 What are the presentations of Scirrhous Carcinoma? | back 190 firm nodule, nonmovable mass |
front 191 What is Medullary Carcinoma? | back 191 malignant breast condition densely cellular tumor. |
front 192 What is the Sonographic Appearance of Medullary Carcinoma? | back 192  Large Resemble fibroadenoma Oval Gently lobulated Hyperechoic Uniform echogenicity Smooth distinct borders Wider than tall Enhancement Edge shadowing |
front 193 What are the presentations of Medullary Carcinoma? | back 193 Discoloration of the overlying skin, bilateral |
front 194 What is Colloid Carcinoma? | back 194 malignant breast condition rare ductal carcinoma 3% of breast cancer |
front 195 What is the Sonographic Appearance of Colloid Carcinoma? | back 195  Salt & Pepper echotexture Resemble fibroadenoma Oval Gently lobulated Hyperechoic Uniform echogenicity Smooth distinct borders Wider than tall Enhancement Edge shadowing |
front 196 What are the presentations of Colloid Carcinoma? | back 196 slow-growing, smooth non-firm palpable mass. |
front 197 What is Tubular Carcinoma? | back 197 malignant breast condition Infectious cystic disease common in sheep herders, a tapeworm that infects. |
front 198 What is the Sonographic Appearance of Tubular Carcinoma? | back 198  Heterogeneous Hypoechoic mass Angular or ill-defined margins Posterior shadowing |
front 199 What are the presentations of Tubular Carcinoma? | back 199 firm palpable mass |