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80-year-old woman with history of breast cancer treatment recalled for large lymph nodes in left axilla

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And our next patient is an 80-year-old

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woman who was treated for

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left breast cancer four years ago.

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She was treated with lumpectomy,

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radiation therapy, and letrozole.

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And, um, at this point, she's, um,

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back in the screening population, so she

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was recalled from screening mammography

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for evaluation of large lymph nodes in the

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left axilla, which were felt to be new.

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These are the screening views for this patient,

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CC and MLO views, and luckily when positioning

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this patient, our technologist was able to get

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a little bit farther back into the left axilla,

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but this was the area that was of concern.

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So, there were multiple surgical clips in

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this area, but then there were three prominent

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lymph nodes as well that were enlarged

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when compared to the previous examination.

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We have tomosynthesis images through

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this, just showing those prominent

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lymph nodes, especially this one.

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And we have the lumpectomy site

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here in the left upper outer breast.

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So, the patient was recalled, and we

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went right to an ultrasound of the

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axilla on the. These were the images.

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And the lymph node is not very large.

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It's only 1.

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3 centimeters, but there's focal

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thickening of the cortex here.

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So, the cortex is relatively thin around

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the corner here, but then right

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in the middle, it's fairly thick up to

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3.5 millimeters in thickness and that

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was the area that was of concern.

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So, that was recommended for ultrasound-

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guided biopsy, which was performed,

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and this was metastatic carcinoma.

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So, the patient had to go on to have

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removal of the lymph node in that area.

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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