RADT-2620: Anatomy And Pathology Of The Breast
RADT-2620: Anatomy and Pathology of the BreastRADT-2620: ANATOMY AND PATHOLOGY OF THE BREASTCuyahoga Community CollegeViewing: RADT-2620 : Anatomy and Pathology of the BreastBoard of Trustees:March 2019Academic Term:Fall 2019Subject CodeRADT - RadiographyCourse Number:2620Title:Anatomy and Pathology of the BreastCatalog Description:Anatomy, physiology and pathology of the breast, including benign and malignantconditions, stages of breast cancer and treatment options.Credit Hour(s):1Lecture Hour(s):1RequisitesPrerequisite and CorequisiteDepartmental approval: admission to Mammography program.OutcomesCourse Outcome(s):Describe breast anatomy and structure.Essential Learning Outcome Mapping:Not Applicable: No Essential Learning Outcomes mapped. This course does not require application-level assignments thatdemonstrate mastery in any of the Essential Learning Outcomes.Objective(s):1. Identify breast anatomy and physiology internally and externally2. Discuss the factors and physiologic changes that will affect breast tissue composition.3. Identify physical changes in the breast.4. Describe breast structure, developmental stages and the differences between the male and the female breast.5. Identify and label the breakdown of a single lobe of the breast.6. Identify the three arterial branches supplying the breast and the three venous drainage channels.7. Describe the lymphatic system and lymphatic drainage.Course Outcome(s):Describe the importance of clinical and self breast examinations and mammograms.Essential Learning Outcome Mapping:Not Applicable: No Essential Learning Outcomes mapped. This course does not require application-level assignments thatdemonstrate mastery in any of the Essential Learning Outcomes.1
2RADT-2620: Anatomy and Pathology of the BreastObjective(s):1. Compare and contrast clinical and self-breast examinations and explain current evidence-based data regarding each practice.2. Identify the significance of breast cancer detection through patient screening and diagnostic mammograms.3. Explain the components and importance of a correlative physical breast assessment.4. Correlate clinical breast changes with imaging findings and comparison with previous mammograms.5. Identify and label mammographic anatomical structures when presented with a mammographic image.6. Correlate breast anatomical structures to mammographic anatomical structures.Course Outcome(s):Explore breast pathologies, detection and diagnosis.Essential Learning Outcome Mapping:Not Applicable: No Essential Learning Outcomes mapped. This course does not require application-level assignments thatdemonstrate mastery in any of the Essential Learning Outcomes.Objective(s):1. Identify the mammographic appearance of pathologies.2. Describe the etiology, mammographic appearance, diagnosis and treatment of benign breast pathologies.3. Describe the etiology, mammographic appearance, diagnosis and treatment of malignant breast pathologies.Course Outcome(s):Identify breast cancer risks, treatment and staging.Essential Learning Outcome Mapping:Not Applicable: No Essential Learning Outcomes mapped. This course does not require application-level assignments thatdemonstrate mastery in any of the Essential Learning Outcomes.Objective(s):1. Identify the high and low risk factors limited to breast cancer.2. Describe assessment categories and the recommended clinical follow up.3. Describe treatment options for breast cancer.4. Explain breast cancer stages 0 to IV and stage charactaristics.5. Explain tumor node metastasis (TNM) classifications of breast cancer.Methods of Evaluation:1. Participation and discussion2. Written assignments3. Case studies4. Exams5. Quizzes6. Other methods deemed appropriate by departmentCourse Content Outline:1. Definition of the Breasta. Male vs. femaleb. Developmental stagesi. Fetalii. Pubertyiii. Menstruationiv. Pregnancyv. Lactationvi. Menopausevii. Post-menopausec. Breast landmarks
RADT-2620: Anatomy and Pathology of the Breast2.3.4.5.i. Quadrantsii. Clock face referencesiii. Region referencesGross Anatomy of the Normal Breasta. External anatomyi. Nippleii. Areola1. Montgomery's glands2. Morgagni's tuberclesiii. Skin1. Sebaceous glands2. Sweat (sudiferous) glands3. Hair folliclesiv. Axillary tailv. Breast margins1. Superior-inferiora. Inframammary fold2. Axillary-medialb. Internal anatomyi. Fascial layersii. Retromammary (fat) spaceiii. Breast parenchymal components1. Fibrous tissues2. Glandular (secretory) tissuesa. Glandular lobesi. Lobulesii. Terminal ductal lobular unit (TDLU)3. Adipose (fatty) tissues4. Connective and support stromaa. Cooper's ligamentsb. Extralobular/intralobular stroma5. Lymphatic channels and drainage from the breast6. Circulatory (blood supply) systema. Arteriesb. Veinsiv. Pectoral muscle1. Location2. Relevancev. Histology of the breast1. TDLUa. Extralobular terminal ductb. Intralobular terminal ductc. Ductal sinus (acinus)2. Cellular componentsa. Epithelial cellsb. Myoepithelial cellsc. Basement membraneMammographic Appearance of Breast Anatomya. External anatomyb. Internal anatomyi. Variancesii. Life cycle changesBreast Anomoliesa. Asymmetryb. Inverted nipplesc. Accessory nipplesd. Accessory breast tissuee. Other (e.g. congenital)Clinical Breast Changes (size, location, duration)3
4RADT-2620: Anatomy and Pathology of the Breasta. Lumpsi. Painii. Mobilityiii. Other associated indications (e.g. trauma, fever, antibiotics)b. Thickeningc. Swellingd. Dimplinge. Skin irritation and lesions (e.g. moles, keratosis, cysts, ulcers, blisters, scaling)f. Paini. New onsetg. Dischargei. New onsetii. Color of dischargeiii. Ipsilateral or bilateraliv. Single duct or multiple ductsv. Spontaneous vs. expressedh. Nipple retraction, inversion and areolar changesi. New onseti. Edemaj. Erythemak. Mammoplastyi. Breast Augmentation1. Typesa. Siliconeb. Saline2. Locationa. Subglandularb. Subpectoralii. Breast liftiii. Breast reductioniv. Otherl. Reconstructive surgeryi. Autologous (e.g. TRAM flap, DIEP flap, latissimus dorsi flap)ii. Tissue expanderiii. Implantiv. Otherm. Postsurgical excisionn. Radiation changeso. Other6. Correlative Physical Breast Assessmenta. Breast examination findings reported by patient or physiciani. Normal breast examination features1. Consistent features2. Variations in parenchyma3. Fibrocystic changesii. Characteristics of abnormal findings1. Redness2. Infectiona. Antibiotic treatment3. Abscess4. Nipple discharge5. Mass6. Breast paina. New onset7. Skin findings8. Nipple findings9. Previous surgeriesb. When to performc. Visual inspection
RADT-2620: Anatomy and Pathology of the Breastd. Palpation techniquese. Documentation of findingsi. In reference to breast landmarksii. Clock face descriptioniii. Accuracy of measurementsf. Radiopaque marking devices (e.g. palpable vs.skin lesions)g. Mammographic correlation7. Mammographic Appearance of Pathology (definition, location)a. Massesi. Margins1. Circumscribed2. Ill-defined (indistinct)3. Lobulated4. Spiculatedii. Asymmetric densityiii. Focal asymmetryiv. Calcifications1. Dermal2. Internal3. Causesa. Cystic changesb. Suturalc. Vasculard. Malignancy4. Characteristicsa. Number (quantity)b. Sizec. Shaped. Distributioni. Clustered or groupedii. Segmentaliii. Regionaliv. Diffuse (scattered)v. Multiple groupsvi. Marginse. Benign characteristics (typical)i. Coarseii. Rim or eggshelliii. Milk of calcium (teacup-like)iv. Dystrophicv. Vascularvi. Skin (superficial)vii. Secretoryviii. Fat necrosisix. Punctatef. Suspicious morphology (nondeterminate characteristics)i. Indistinct (amorphous)ii. Pleomorphic, glanular (clustered)iii. Irregulariv. Linearv. Casting8. Reporting Terminology (e.g. BI-RADS)a. Assessment categoriesb. Recommendations9. Benign Breast Pathologya. Etiology, mammographic appearance, diagnosis and treatmenti. Cystii. Galactoceleiii. Fibroadenoma5
6RADT-2620: Anatomy and Pathology of the Breastiv. Lipomav. Hamartoma (fibroadenolipomaj)vi. Papillomavii. Ductal ectasiaviii. Breast infection/abcessix. Hematomax. Fat necrosisxi. Radial scarxii. Lymph nodexiii. Gynecomastia10. High Risk Breast Pathologya. Etiology, mammographic appearance, diagnosis and treatmenti. Atypical ductal hyperplasiaii. Papilloma with atypiaiii. Papillomatosisiv. Atypical lobular hyperplasiav. Lobular carcinoma in-situvi. Phyllodes tumor11. Malignant Breast Pathologya. Etiology, mammographic appearance, diagnosis and treatmenti. Ductal carcinoma in-situii. Invasive/infiltrating ductal carcinomaiii. Invasive lobular carcinomaiv. Pagets diseasev. Sarcomavi. Tubularvii. Medullaryviii. Mucinousix. Papillaryx. Metastatic carcinoma12. Breast Cancer Classificationsa. Stage Characteristicsi. Description1. Size2. Invasive vs. noninvasive3. Lymph node involvement4. Spread beyond the breastii. Stages1. Stage 02. Stage I3. Stage II4. Stage III5. Stage IVb. TNM classification characteristicsi. TNM description1. Size2. Lymph node involvement3. Metastasisii. T-size1. TX2. T03. Tis4. T1, T2, T3, T4iii. N-lymph node involvement1. NX2. N03. N1, N2, N3iv. M-metastasis
RADT-2620: Anatomy and Pathology of the Breast1. MX2. M03. M1c. Cell gradei. Definitionii. Grade 1iii. Grade 2iv. Grade 3d. Multifocale. Multicentricf. Hormone receptors and HER2i. Importance of testsii. Estrogeniii. Progesteroneiv. HER213. Hormonal Influencesa. Birth control pillsb. Estrogenc. Progesteroned. Prolactine. Testosteronef. OtherResourcesAmerican College of Radiology (ACR). ACR Mammography Manual, Reston, VA.American Registry of Radiologic Technologists (ARRT). (Current) Content Specifications for Mammography. St. Paul, cifications.pdf?sfvrsn 8a6303fc 8American Society of Radiologic Technologists (ASRT). (2018) Mammography Curriculum, Albuquerque, NM. urriculum.pdfCardenosa, Gilda. (2018) Breast Imaging Companion, Philadelphia: Wolters-Kluwer.Lille, Shelly L. Marshall, Wendy. (2019) Mammography Imaging--A Practical Guide, Philadelphia: Wolters-Kluwer.Peart, Olive. (2018) Mammography and Imaging Prep: Program Review and Exam Prep, New York: McGraw-Hill.Peart, Olive. (2018) Lange Q and A: Mammography Examination-A Practical Guide, New York: McGraw-Hill.Resources OtherU. S. Department of Health and Human Services. Quality Determinants of Mammography Clinical Practice Guidelines.Top of pageKey: 38647
1. Identify breast anatomy and physiology internally and externally 2. Discuss the factors and physiologic changes that will affect breast tissue composition. 3. Identify physical changes in the breast. 4. Describe breast structure, developmental stages and the differences between the male and the female breast
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