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32-year-old woman, 1 year postpartum, breastfeeding, with palpable lump left breast

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Our next patient is a 32-year-old woman.

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She's one year postpartum and she's breastfeeding

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with a palpable lump in the left breast.

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So for this patient, we started with

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ultrasound in the area of palpable concern.

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This was in the left upper outer breast.

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You can see some heterogeneous breast

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tissue, a little bit hypoechoic, but it

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wasn't particularly concerning and it

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was a fairly widespread area, but this was

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palpable and the patient felt like it

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was different than it had been before.

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And maybe some parts of it

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are a little bit more focal.

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The technologist had the presence of

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mind to check the opposite side as well.

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So they were looking at the right upper

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outer breast and really the right upper

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outer breast just looks like normal tissue.

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So it's missing that whole hypoechoic,

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heterogeneous area.

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And, you know, even though it could

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be, maybe it could be normal variant,

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this was actually the palpable area.

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So it was good to compare to the other side just

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to show that that was very different looking.

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This was palpable.

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So a decision was made to biopsy this area.

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So a biopsy was performed,

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and showed ductal carcinoma

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in situ in this tissue.

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So the next step was to,

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uh, look with mammography.

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So a mammogram was done.

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So this is the patient's bilateral

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mammogram, which was a 2D exam,

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but you can see that the biopsy clip is

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here in the left upper outer breast.

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But the other thing that you can see

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is that it's surrounded by a lot of

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coarse, heterogeneous calcifications.

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They're basically in the whole

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outer half of the breast.

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So this is the DCIS that was of concern.

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So here it is on the MLO view,

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really going all the way out to here.

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Every place you look, there's calcifications.

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And we didn't see anything on the other side.

Report

Faculty

Lisa Ann Mullen, MD

Assistant Professor; Breast Imaging Fellowship Director

Johns Hopkins Medicine

Tags

Women's Health

Ultrasound

Neoplastic

Mammography

Breast

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