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