Interactive Transcript
0:01
And this is another case of 49 year old woman with a
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recent diagnosis of right inflammatory breast cancer.
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So she had a red inflamed
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right breast with orange peel skin, or peau d'orange.
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And this is usually related to
0:22
breast cancer metastasis within the dermal lymphatics.
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Sometimes we see
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just a very edematous breast over a breast cancer,
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but in this case, it was inflammatory breast cancer
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and we were asked to assess extent of disease.
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So just showing you her maximum intensity projection image.
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You can see that the entire right breast is abnormal,
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the skin is enhancing, most of the breast enhances.
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There are abnormal lymph nodes.
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The left breast looks relatively quiet.
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And we'll take a look at this a little further.
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So here are our T1-weighted
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non-fat saturated images and our T1-weighted first post
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contrast subtraction images.
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And you can see that the patient is prone and you can
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see that the breast don't move in the same way.
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So this breast is moving normally,
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but this breast is just kind of
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solid,
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it doesn't have the same kind of contour as the left breast.
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Her skin is diffusely thick.
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And you can see that on this T1-weighted image.
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And on the post contrast image,
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you can see that the skin enhances diffusely.
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There's also diffuse enhancement of the,
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of the breast.
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And you can see that there is a mass here in the upper outer
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right breast, and that has already been biopsied with
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diagnosis of breast cancer.
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But there's fairly extensive non mass enhancement,
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mostly in the lateral breast, but really throughout the breast.
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And then the skin is very,
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very thick and enhances diffusely.
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So this is an inflammatory breast cancer and a BI-RADS 5.
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I mean, it was known that this was a breast cancer but the extent
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of disease was not known at the time of the MRI.
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The other thing that we noticed that we were very
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worried about is that she has bilateral axillary adenopathy.
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So just looking at that again.
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So all of these lymph nodes in the underarm are abnormal,
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both on the right and the left, and there,
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as we scroll through, there are a lot of abnormal lymph nodes.
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And we thought that these were probably involved
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and we recommended a biopsy of an
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axillary lymph node on each side.
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And what we got us our answer,
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So that was done with ultrasound guidance and we
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thought metastatic disease with the breast primary
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and we got that result from both
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the right and the left side.
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So BI-RADS 5 inflammatory breast cancer on the
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right bilateral axillary adenopathy.
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