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56-year-old woman for follow up of probably benign clustered microcysts in right breast

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Our next patient is a 56-year-old

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woman for follow-up of probably benign

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clustered microcysts in the right breast.

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So, here's our patient CC and MLO views.

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I think we were at the one-year follow-up

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point, and that's why we did a bilateral exam.

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And we were going on to ultrasound

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to evaluate the clustered microcysts

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that had been seen previously.

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And as we scrolled through

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everything, the left side looked fine.

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The finding of interest was on the right side.

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What we were interested in

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was that we really couldn't see the clustered

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microcysts, but what we did notice was an

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asymmetric density in the lateral right breast.

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So as we scroll through her images,

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it was this density, maybe even a

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little distorted, that caught our eye.

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So we had that area, and we thought

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that she had had an asymmetry

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before, but it maybe looked worse.

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And here it is on this view, just

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going through the tomosynthesis images.

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There definitely seems to be

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something a little asymmetric there.

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So we did some extra work on that area,

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because that had not been on the radar before.

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So we did a spot compression view

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with tomosynthesis, and there's,

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you know, definitely some density there.

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And then a spot compression MLO view.

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Still seeing something there.

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It doesn't really fade or

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go away as we're imaging.

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So when we went to ultrasound, we're not only

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looking for the clustered microcysts that we

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were supposed to be following, but also this

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area of concern in the upper outer right breast.

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So here's our little clustered cysts that

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we're not very worried about; very small area.

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And then we had this

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hypoechoic mass with posterior acoustic

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shadowing, a lot of internal blood flow.

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And this is at the 10 o'clock position,

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11 centimeters from the nipple.

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So here it is in radial and antiradial.

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And it probably isn't quite as

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big as what's measured here.

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It's probably only this big,

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but has a lot of posterior shadowing.

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So this is really a very suspicious finding.

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The clustered microcysts were not suspicious,

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but this new area is very suspicious.

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So we recommended biopsy for this,

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and this was an invasive ductal carcinoma.

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So I think it's important to keep in mind

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that even though you're following up some

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probably benign area that isn't worrisome,

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you have to always be on the lookout for

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cancer is developing in that area or some

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other part of that breast or the other breast.

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So, even though it seems like an easy task to

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follow up the probably benign finding, be on

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the watch for either the lesion growing or

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changing or some other lesion requiring biopsy.

Report

Faculty

Lisa Ann Mullen, MD

Assistant Professor; Breast Imaging Fellowship Director

Johns Hopkins Medicine

Tags

Women's Health

Ultrasound

Tomosynthesis

Non-infectious Inflammatory

Mammography

Breast

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