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57-year-old woman with history of right breast cancer 10 years ago. Annual follow up

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So our first case is a 57-year-old woman with

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a history of right breast cancer 10 years ago,

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who's having a routine annual follow-up.

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And, you know, some of our patients, some of

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our referring providers will request diagnostic

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imaging every year for their patients, regardless

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of how long ago their breast cancer was.

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And we, we honor those requests.

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So this is the bilateral mammogram

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on a patient who has had a history

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of right breast cancer in the past.

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And just looking at this right breast a little

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bit more closely, um, this is the CC view.

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There's distortion here at the lumpectomy site.

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All of these surgical clips are

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here marking that lumpectomy site.

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And there's some coarse dystrophic

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calcification centrally.

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And as we scroll through the tomosynthesis

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images, we're just getting distortion

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at that central lumpectomy site, her

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nipples a little bit displaced under.

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Everything else looks good.

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So distortion at the lumpectomy site,

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expected changes, we would compare to multiple prior

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mammograms and We found that there was no change.

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And here's her, um, MLO view,

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so we've got that distortion.

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Just looking at her tomosynthesis images,

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you can see that her skin is pulled in here

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where she has The post-surgical scar, we've

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got surgical clips and distortion, central

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dystrophic calcifications, but nothing suspicious.

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And again, we had compared this to multiple

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prior studies and there was no change.

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And of course, we're also

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interested in the opposite breast.

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So we look at that carefully because this is

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essentially a screening exam for both breasts.

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So we're comparing to prior exams and

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all of her asymmetries were stable.

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There's the left MLO view and tomosynthesis views.

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She does have a few little areas of asymmetry,

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but those were stable compared to prior studies.

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So the lumpectomy site looks fine and

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there's nothing new in either breast.

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We would give this a BI-RADS Category 2, benign,

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and we'd recommend annual screening mammography

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because it's been under our protocol more than

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three years since her breast cancer treatment.

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She and her provider may decide to have

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diagnostic mammography yearly, which is fine.

Report

Faculty

Lisa Ann Mullen, MD

Assistant Professor; Breast Imaging Fellowship Director

Johns Hopkins Medicine

Tags

Women's Health

Tomosynthesis

Non-infectious Inflammatory

Mammography

Breast

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