54-year-old woman recalled for distortion in left anterior breast
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Our next patient is a 54-year-old
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woman recalled for evaluation of
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distortion in the left anterior breast.
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These are the screening mammogram views for
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this patient, CC and MLO views, and you can
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see that there's something wrong with the
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anterior medial tissue in the left breast.
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Everything else looked stable, but just looking
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at this a little bit more closely, you can
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see this distortion of the tissue with these
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radiating lines kind of coming into a central
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point, and that was the recalled finding.
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I think it's probably best seen on this
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CC view, but you can see it here on the
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tomosynthesis images here at that point.
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medial margin of the tissue,
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the tissue is distorted.
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You can also see it on the MLO (mediolateral oblique) view
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and the MLO tomosynthesis images.
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There's distortion right in here.
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So when the patient returned, we did a
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spot compression view in the CC projection
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and you can still see that, maybe see
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that distortion a little bit better.
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And here's the tomosynthesis
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through that spot compression view,
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showing that distortion.
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And then we did a spot
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compression in the MLO projection.
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You can see that distortion here.
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And this is the tomosynthesis view
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again, showing that radiating lines
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coming into a point with distortion.
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So next we looked with ultrasound to see
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if we could find a mass in that location.
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'Cause that seems likely.
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So here's our ultrasound.
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And in the 9 o'clock periareolar breast,
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we see this hypoechoic irregular mass that
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corresponded with the area of distortion.
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And it's about a centimeter and a half in the
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anteriormedial plane and a little bit larger,
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1.8 centimeters in the radial plane.
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With some central blood flow.
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We also looked at the axillary lymph nodes,
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which looked small and normal in size.
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So our recommendation was an ultrasound
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guided biopsy of this area, and that
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was an invasive ductal carcinoma.
Lisa Ann Mullen, MD
Assistant Professor; Breast Imaging Fellowship Director
Johns Hopkins Medicine
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