0:00

Our first case is a 39-year-old woman who

0:04

presented to the emergency room with fever

0:07

and symptoms of cellulitis of the right

0:09

breast, and we were asked to evaluate

0:12

for an abscess, and interestingly,

0:15

the patient had recently stopped breastfeeding.

0:18

So often our patients that have these acute

0:22

problems are evaluated through the adult, uh,

0:25

emergency department, so they may get, um,

0:28

an ultrasound performed and interpreted by our body

0:32

imaging team rather than breast imaging and, uh,

0:36

sometimes they'll come to us for follow-up later.

0:40

So this was our patient and just scrolling

0:46

through, we can see that the skin is thick.

0:49

So we're starting with.

0:50

Ultrasound, because that's what's

0:52

available in the emergency department.

0:54

So skin thickening, the subcutaneous fat, instead

0:58

of being a medium gray, is kind of a lighter gray

1:02

color, a little bit more echogenic than normal.

1:04

And there's a little bit of fluid

1:06

tracking through the tissue.

1:08

So the tissue's edematous.

1:10

When we put Doppler, color on.

1:13

Um, there's increased vascularity to that tissue.

1:17

And as we get into the tissues,

1:19

there's some more hypoechoic areas, really no

1:22

drainable fluid collection, very vascular.

1:28

See this in the other direction.

1:31

So lots of echogenic fat lobules

1:40

and that very hypervascular

1:41

tissue.

1:42

So that's the right breast.

1:43

They looked at the left breast for comparison.

1:46

And it looks much different, so it doesn't have

1:50

that edema and, um, the vascularity is normal.

1:54

So this was thought to represent

1:58

mastitis without an abscess.

39-year-old woman with fever and cellulitis of the right breast, recently stopped breastfeeding

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0:00

Our first case is a 39-year-old woman who

0:04

presented to the emergency room with fever

0:07

and symptoms of cellulitis of the right

0:09

breast, and we were asked to evaluate

0:12

for an abscess, and interestingly,

0:15

the patient had recently stopped breastfeeding.

0:18

So often our patients that have these acute

0:22

problems are evaluated through the adult, uh,

0:25

emergency department, so they may get, um,

0:28

an ultrasound performed and interpreted by our body

0:32

imaging team rather than breast imaging and, uh,

0:36

sometimes they'll come to us for follow-up later.

0:40

So this was our patient and just scrolling

0:46

through, we can see that the skin is thick.

0:49

So we're starting with.

0:50

Ultrasound, because that's what's

0:52

available in the emergency department.

0:54

So skin thickening, the subcutaneous fat, instead

0:58

of being a medium gray, is kind of a lighter gray

1:02

color, a little bit more echogenic than normal.

1:04

And there's a little bit of fluid

1:06

tracking through the tissue.

1:08

So the tissue's edematous.

1:10

When we put Doppler, color on.

1:13

Um, there's increased vascularity to that tissue.

1:17

And as we get into the tissues,

1:19

there's some more hypoechoic areas, really no

1:22

drainable fluid collection, very vascular.

1:28

See this in the other direction.

1:31

So lots of echogenic fat lobules

1:40

and that very hypervascular

1:41

tissue.

1:42

So that's the right breast.

1:43

They looked at the left breast for comparison.

1:46

And it looks much different, so it doesn't have

1:50

that edema and, um, the vascularity is normal.

1:54

So this was thought to represent

1:58

mastitis without an abscess.

Report

Faculty

Lisa Ann Mullen, MD

Assistant Professor; Breast Imaging Fellowship Director

Johns Hopkins Medicine

Lesson

Sample Lesson

Lesson

Palpable Lumps

Lesson

Breast Pain

Lesson

Nipple Discharge

Lesson

Skin Changes/Inflammation

Lesson

Recall from Screening

Lesson

Surveillance After Breast Cancer Treatment

Lesson

Follow Up Probably Benign Findings - BI-RADS 3

Lesson

Follow up Benign Biopsy

Lesson

Pregnant and Lactating Women

Lesson

Male Patients

39-year-old woman with fever and cellulitis of the right breast, recently stopped breastfeeding