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.
Lisa Ann Mullen, MD
Assistant Professor; Breast Imaging Fellowship Director
Johns Hopkins Medicine
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