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BI-RADS 6 – Left Breast Cancer, Index Mass

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Our next patient is a 42 year old woman with

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a recent diagnosis of left breast cancer,

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and MRI is being performed to assess extent of disease.

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So here's the patient's MIP,

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and you can see that there's a large enhancing mass here,

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posteriorly in the left breast and some lymph nodes, bilaterally.

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She has a lot of little foci in both breasts,

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likely related to background parenchymal enhancement.

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We'll take a look at our T1 and our subtraction series.

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And we can see that she has heterogeneous background

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parenchymal enhancement, or background tissue.

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And then she has a moderate background

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parenchymal enhancement.

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But a lot of this is just scattered foci,

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nothing really suspicious.

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Then we get into this enhancing mass.

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There's artifact from a biopsy clip internally.

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And surprisingly,

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you know,

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sometimes with a mass, this size will see

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abnormal lymph nodes,

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but her lymph nodes are normal in appearance,

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bilaterally.

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One thing that we always want to be aware of

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when we're looking at a breast cancer that's more medial,

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which this is,

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we want to be sure to check our internal

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mammary lymph nodes, which we did.

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And here they are, internal mammary artery and veins.

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We're going to follow those, and basically no

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visible lymph nodes.

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So really just the one cancer and some background.

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We can see this on T1-weighted series pre and post contrast.

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Nothing else that we can see there.

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And you can see based on how I'm

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reviewing these studies, that although we have

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all these series, we may not use them very much other than for

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kinetics or trying to figure something out.

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Our pre and post contrast series with our sub

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and our MIP are going to be the most important things

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that we look at with some contribution by the T1

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non-fat saturated and STIR sequences.

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And if you think about it,

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most abbreviated protocols at this point are

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T1-weighted pre and post contrast

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and maybe

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maybe a STIR or some sort of

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T2-weighted sequences added as well.

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But that, that forms the bulk of what we look at.

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And then the second and third and subsequent sequences

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after contrast are mostly to get information about kinetics.

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But I'm showing you the second and third sequence here,

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I don't think it contributes a whole lot to our

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overall understanding of this patient.

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Okay, so this was a BI-RADS 6.

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She only had the index mass and nothing

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else that we were worried about.

Report

Description

Faculty

Lisa Ann Mullen, MD

Assistant Professor; Breast Imaging Fellowship Director

Johns Hopkins Medicine

Tags

Women's Health

Neoplastic

MRI

Breast

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