0:00

Alright, that should have loaded by now.

0:02

So let's go back and see if it's...

0:04

There we go.

0:06

So, let's spin this one.

0:09

So look, first of all, at the MIP subtraction on your right side,

0:14

and forget this is a comparison to the case of ductal ectasia

0:18

that we saw previously.

0:30

One of these is back to front, so...

0:34

Let me get them so they're both the same way around.

0:37

So the left breast, which is abnormal.

0:40

Here we go.

0:43

Stop.

0:45

Apparently, it wants to do its thing.

0:49

So I'm going to scan up and down the left breast here.

0:51

Really, all the information you need is on these two images.

1:07

And let's put the question up here.

1:10

I can put the CAD up while

1:14

that's doing it.

1:18

Yes. Excellent.

1:19

So this one,

1:21

which was case 9,

1:24

is DCIS.

1:25

So again, it's ductal type enhancement.

1:28

It's following those ducts very clearly,

1:31

but unlike the prior case, which although

1:36

it was high on the T2, gad was negative on the subtraction.

1:39

This one has clear enhancement on the subtraction and it's also not smooth.

1:44

It's, again, this is...

1:46

it's what we've,

1:46

you know,

1:47

clumped type ductal linear enhancement.

1:52

It's very much forming a segment directed

1:56

towards the nipple, which makes us think of DCIS.

1:59

Could this be papillomatosis?

2:01

It could be.

2:02

The fact that it is in one segment makes me, less likely,

2:08

it's clearly got to be biopsied.

2:10

If it came back as papillomatosis,

2:12

I wouldn't drop dead and surprised, but it's more likely to be DCIS.