74-year-old woman recalled for architectural distortion in left breast
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So our next patient is a 74-year-old woman,
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recalled from screening mammography for evaluation
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of architectural distortion in the left breast.
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So for this patient, this was her
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screening mammogram, and we were concerned
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about architectural distortion in the
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left breast, left upper outer breast.
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And this is pretty subtle and kind of
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confounded by the fact that there's a calcified
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artery kind of running right on top of it.
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But the 3D really helped here, and we thought
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that right in here, there was some distortion
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of the tissue, where the tissue was pulled in.
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There's our artery, and it was
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kind of right in this spot.
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And on the MLO (mediolateral oblique) view, we thought
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it was kind of up in this area.
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So very far lateral, but up in that spot.
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So, when the patient came back,
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we did some additional imaging, including
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spot compression in the CC plane.
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Here's the spot compression CC (craniocaudal),
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and this is the tomosynthesis image.
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Still looks like there's some
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lines coming into a central point.
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This distortion is really pretty
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subtle, but it's right in there.
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And then we did an MLO spot.
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Thinking that it was probably in this area,
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felt like it was in this, in this area.
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And then we also did a lateral view.
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We thought the distortion was right in here.
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So we recommended a tomosynthesis-guided biopsy
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from a lateral approach, and that was performed.
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And this was an invasive lobular carcinoma.
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So very subtle, but it was actually a cancer.
Lisa Ann Mullen, MD
Assistant Professor; Breast Imaging Fellowship Director
Johns Hopkins Medicine
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