59-year-old woman recalled for focal asymmetry in left breast
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Our next patient is a 59-year-old woman
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who was recalled from screening mammography
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for evaluation of a left breast asymmetry.
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So here's the screening
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mammogram for this patient.
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And the area of interest that was indicated by
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the colleague who read the screening mammogram
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was this area down here, left medial breast on the
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CC, and it was left lower breast on the MLO (mediolateral oblique) view.
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And if we look at that a little bit more
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closely, I'm just going to pull up her
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tomosynthesis images and see this area here
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and then on the MLO view.
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This MLO, it looks almost like there's
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a border, like this may actually be a
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mass, but it was recalled as an asymmetry.
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So then when we brought the patient
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back, since it was called an asymmetry,
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we did the spot compression views first.
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So here's the spot compression in the CC view.
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And already this is starting to shape up a little
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bit more like a mass, like it has borders to it.
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And this is the spot
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compression tomosynthesis image.
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And you can really see now that those borders
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are starting to appear a little bit more.
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I think this is one of the advantages of spot
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compression, even in the era of tomosynthesis.
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So she has a few different
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masses, but this is the main one.
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And then we did the MLO view as well.
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This was her spot compression view.
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And then this was the tomosynthesis where you can
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kind of see that oval, partially obscured mass.
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showing up there on the spot compression.
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So we went ahead and did ultrasound as our
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next step, and this was her ultrasound.
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Basically, showing in the left breast
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at the 9:30 position, so medial left
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breast, 3 centimeters from the nipple,
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there's a fairly large simple cyst.
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And that was the area that corresponded.
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There are a few other smaller cysts,
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but this was the main finding.
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So this was an example of a developing asymmetry
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that turned out to be a benign simple cyst.
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So we considered this to be BI-RADS 2,
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benign finding, and the patient would
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return to annual screening mammography.
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No special follow-up.
Lisa Ann Mullen, MD
Assistant Professor; Breast Imaging Fellowship Director
Johns Hopkins Medicine
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