62-year-old woman with history of left breast cancer 4 years ago. Annual follow up
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Our next patient is a 62-year-old woman with
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a history of left breast cancer four years
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ago, and she's here for annual surveillance.
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So here are the standard CC and MLO views for
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our patient, and this patient is heterogeneously
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dense, so considerably greater breast tissue
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density than the last patient we looked
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at, and her cancer was in the left lateral
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posterior breast, and just looking at her.
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Her tissue looks fine, looks unchanged.
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We had tomosynthesis images, everything
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looking good.
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We, um, mark the patient's scar on
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her skin with a scar marker, but
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her breast cancer was way back here.
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You know, if we have images from the time that
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the patient was diagnosed, I always want to see
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where the actual cancer was, because sometimes
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the scar on the skin is at some distance away.
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If the surgeon has made a periareolar scar and then
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tunneled under to get to the area of interest.
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So this is the MLO view for the same
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patient, and you can see that her lumpectomy
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site is actually pretty far posterior.
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But really no change from her prior study.
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She does have post-lumpectomy changes.
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This is also a patient who, because
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of her very dense tissue, she gets an
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annual MRI in addition to mammography.
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So, you know, we don't add anything
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else at the time of her surveillance.
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So, you know, unless there's something
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new, we wouldn't do an ultrasound.
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She also has the other breast.
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There was a mass here that has
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been stable for a long time.
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So nothing new there either.
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Looking at all of her tomosynthesis
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images and her tissue looks
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stable.
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The right CC, she's had a biopsy
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up here, and there's that very far
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posterior lateral mass and biopsy clip.
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So after we've looked at all of these images
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and compared to previous and decided that
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there's, you know, nothing else that has to be
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done, we would RADS category benign findings.
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And then, um, she would have
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routine follow-up in one year.
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Since she's four years out, we would suggest
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a screening mammogram, but she may end up
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with a diagnostic mammogram yearly, depending
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on her preference and provider preference.
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And then she would also have an annual MRI.
Lisa Ann Mullen, MD
Assistant Professor; Breast Imaging Fellowship Director
Johns Hopkins Medicine
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