47-year-old woman recalled for asymmetry in left breast
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So our first case is a 47-year-old woman who
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was recalled from screening for evaluation
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of an asymmetry in the left breast.
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So this is the screening mammogram on this patient
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who was being recalled for a one-view asymmetry.
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And the area of interest was this area
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of tissue density here in the left,
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central to slightly medial breast.
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So we always want to go back to the
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screening mammogram and see, you know,
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what was the area that was of concern?
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And then, you know, maybe check a prior mammogram
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to see was this really new from previous?
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Did it always look like that?
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Would we have recalled this ourselves?
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And then we'll go ahead and do our exam.
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18 00:00:48,025 --> 00:00:50,455 So the first thing we do is repeat the
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full CC view because it was a CC view
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that showed this finding to begin with.
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So here it was on the prior exam.
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And when we look at the repeat CC
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view, that tissue sort of separates
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out, just looks like normal tissue.
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We'll go ahead and look through
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the tomosynthesis image.
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And we know it was kind of in here
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that there was that asymmetry.
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But this looks great on the repeat CC view.
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We also did a spot compression view of that
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area and looked through that with tomosynthesis.
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Really just looks like normal tissue
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and of course we would be comparing
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this to the patient's earlier prior.
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exams and this was the full lateral view,
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just to give us a different angle on that tissue.
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You know, one could make the argument that
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maybe just the repeat CC view alone would be
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enough, but in a busy diagnostic center, we try
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to minimize the trips that the patient
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makes in and out of the mammography room.
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So, you know, we would go ahead and
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do that repeat full CC, the spot
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compression, and the lateral view.
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And then, um, you know, have the
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patient wait in the waiting room while
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the radiologist reviews all of these.
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And, you know, we try to minimize what we do,
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but we also want to make sure it's effective and
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that it's efficient with minimizing the trips
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of the patient in and out of the waiting room
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and back into the mammography viewing area.
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So in this case, we felt that, um,
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the asymmetry resolved with these extra images.
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The tissue looked just like it had on earlier
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prior mammograms and, um, there's really no
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target for an ultrasound in this situation.
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So we considered that this asymmetry resolved.
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Probably just related to
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superimposed breast tissue.
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And we would, you know, consider this normal
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BI-RADS 1 assessment, and we would return the
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patient to screening mammography in one year.
Lisa Ann Mullen, MD
Assistant Professor; Breast Imaging Fellowship Director
Johns Hopkins Medicine
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