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.
Lisa Ann Mullen, MD
Assistant Professor; Breast Imaging Fellowship Director
Johns Hopkins Medicine
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