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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.

Report

Faculty

Lisa Ann Mullen, MD

Assistant Professor; Breast Imaging Fellowship Director

Johns Hopkins Medicine

Tags

Women's Health

Ultrasound

Tomosynthesis

Neoplastic

Mammography

Breast

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