Interactive Transcript
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In this case, we have a 38 year old female presenting with bilateral
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axillary palpable findings, which have been present for some time, and she
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comes in for further imaging evaluation. Now, we'll start with, again,
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looking at our overall full field CC and MLO views. In this patient,
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she had no prior history of having any imaging, so nothing to compare
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to, so we'll get all the full field views as well.
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We have pretty good image quality, I would say. The pectoralis muscles do
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not come down all the way to the level of the nipple, so
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we would hope to get even a little more pectoralis muscle in these
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images. Now, it's probably okay, probably adequate for what we need for
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today's exam, but you might wonder or ask your technologist about this,
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potentially. Sometimes patients are more difficult to pull on, particularly
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those patients with more dense breasts. So, let me first adjust the CC views
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for us. In the CC views, the SM views here,
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we notice that there's no BB marker in the CC, as far as
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we can tell. Now, we would expect it in the lateral aspect of
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the breast, because we know that these were axillary findings, but we also
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sort of don't expect to see them, because
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it's very difficult to get axillary tissue on a CC view. Now, our technologist
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did try XCCL views in this case, and again, we still don't see
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any palpable marker on the CC view. Now, we'll look at the rest
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of the breast, just to make sure we're not missing anything else,
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but we don't see anything abnormal in this case. Technologists will do spot
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compression views over the palpable abnormality. In this case, they were
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able to get the axillary palpable findings very high up in the axilla. We
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can see our markers here and here. And if we switch over to
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the DVT views, we can scroll through the imaging stack to take a
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closer look. Now, of course, in this case, we'll start in the lateral
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aspect and move immediately. Our palpable BB marker is coming into view.
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And underlying, we see some wispy fibroglandular tissue, which is directly
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underlying that marker. And then we also can see some normal appearing axillary
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lymph nodes. Now, it's a little bit unclear whether she's feeling maybe
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that axillary tissue or the lymph nodes, but it's something we can ask
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her as a technologist to confirm with the patient.
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Similarly, on the left side, we see the palpable BB marker is just
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at the margin of our spot compression paddle. And underline, we again see
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this sort of normal wispy fibroglandular tissue, and then again, some normal
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left axillary lymph nodes. Now, in this case, the patient did go on
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to ultrasound. She had bilateral axillary ultrasound, which showed both
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of these findings. Again, some normal axillary glandular tissue, some normal
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appearing lymph nodes, all looked well. It's very likely that she's feeling
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a little bit of this axillary tissue, and for whatever reason,
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just happened to feel it at that point.
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But she can be reassured and sent back to her
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referring provider and just undergo routine screening, preferably at age
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40.
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