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75-year-old man, BRCA2 carrier, with palpable lump in right breast

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Next patient is a 75-year-old man with a palpable

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lump in the right breast, and the patient recently

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learned that he's a BRCA2 gene mutation carrier.

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So that's pretty unusual.

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So, for this man with a palpable mass,

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we did a bilateral diagnostic mammogram.

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We put a triangular skin marker on the area

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of palpable concern, which was in the

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right breast, and it corresponds to this.

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Dense mass in the right upper outer breast.

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And incidentally noted, there was a dense

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mass in a similar position on the left side,

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which the patient and clinician did not feel.

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There's really not much in the way of

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gynecomastia, maybe a tiny little bit of

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tissue behind the nipple, but not much.

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The rest of the tissue is fatty.

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So, we went ahead and did an ultrasound for

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this patient, and this is the mass on the right,

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seven o'clock, two centimeters from the nipple.

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So there's an irregular hypoechoic mass,

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and we had, I think we have a little cine clip

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through it just to show that, and it is about

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1.7 centimeters in greatest dimension.

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And then on the left, we have

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this mass, also a hypoechoic mass.

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Here's our CineClip going through,

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and there's some measurements, so it's

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1.6 centimeters, so almost a mirror image of

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the one on the right side, so hypoechoic,

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kind of an angular to microlobulated

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border, and about the same size.

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And then lymph nodes looked fine.

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So we recommended ultrasound-guided

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biopsy of both of these masses, and they

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were both invasive ductal carcinomas.

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Male patient with new realization

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of BRCA2 gene mutation status.

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So he ended up being treated

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with bilateral mastectomy.

Report

Faculty

Lisa Ann Mullen, MD

Assistant Professor; Breast Imaging Fellowship Director

Johns Hopkins Medicine

Tags

Ultrasound

Neoplastic

Mammography

Male

Breast

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