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Hi everyone. Thank you for joining me this afternoon.

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So via a comprehensive Breast Care Center at

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a large Hospital many patients come to our

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facility for Signal opinions.

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So I'm going through five clinical cases

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from the outside facilities.

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They are Miser management and Communications. Hopefully

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by the end of this lecture. We will

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be able to learn something from this outside cases how

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to avoid the mistakes and

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managing our avoid World

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complications.

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Case number one a 45 year

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old woman at a recent diagnosis of

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a 2.8 centimeter infiltrating memory

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cancer in the right upper

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outer breast at the outside

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of facility.

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She was referred to our breast clinic for a

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lumpectomy.

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So outside the post about biopsy mammogram

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are June over here in the biopsy

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side or labeled with this star over

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here. So based on this.

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Mammogram was your recommendation.

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We'll just give you a few seconds to you. Think

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about the answer over here.

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Okay, great.

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Let's check the answer over here.

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Okay, the correct answer is MRI. So

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just the based on the mammogram.

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You can see that the right breast

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one compared to the left breast. It's a

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smaller right when this happened to you at a

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clinic. Normally they are two scenes if you need to check.

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Number one we would like to compare to the

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prior exam if you available.

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To see if a patient just you know, has this asymmetrical

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breast over time just

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the patient's normal, right?

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Number one number two, it could be just positioning.

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But in this case, we compared to the prior the patients

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that you know write a breast is always it's smaller

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only this year and also on both

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the envelope you and CCC both us

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more over here.

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So this is not something has

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been always like it is just another

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positioning.

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Of this so this something wrong with the right

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breast.

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So the correct answer is to see because we need

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you a performer MRI to find out

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additional fundings in this press you cannot

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go ahead and do the needle localization and the

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nonpectomy.

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Because there is more things going on in

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the right breast.

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At this point, I don't think we are ready to go with the

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bones again or CT chairs. That's a

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4D a system chemical evaluation of

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the disease all that we get the

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four picture of what's going on in the

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right breast locally

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Next question. So the breast MRI.

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It's performed and those are the Imaging over

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here. That's the mid Imaging. That's

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the subtraction Imaging of

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the contrast.

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With this color map over here.

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So my question for you is how often

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additional cancer is found in

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the EBC labor, press on a pre-op

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MRI.

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Let's look at the answer together.

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The correct answer is a c 8 to 16%

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based on the literary in the ipsilateral breast additional

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suspicions and lesions are often

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seen in 29% of cases.

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Approximately half of them turned out to be

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malignant.

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On their contralateral breasts additional social

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Solutions are often seen in 19% of

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the cases.

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Only in court hold for them become malignant.

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So the correct answer for this for the ipsilateral

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breasts is approximately 8 to 16% And

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for the contralateral breast is

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approximately one to five percent.

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A and B is just a too high because it's

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the our question is the additional

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cancer not additional mission.

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another question

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Which pathological condition is often

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associated with a shrinking breast?

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Hopefully by this point you guys are all realize that

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this is a healing Breath Right.

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Okay, right. Let's look at the answer together. Thank

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you for answering that.

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The correct answer is infiltrating login

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carcinoma.

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Inflammatory breast cancer often present

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with a receima and also as swelling

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data plastic cancer normally just

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grow very fast.

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You basically doctor across Noma can prison as

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the main faces normally within the sea

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regular Mass asymmetry.

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Chewing compress is not a typical appearance of the

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invasive doctoral carcinoma. Unless it's

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become very Advanced and diffused.

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another question

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We tell their falling in statements about infiltrating lobular.

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Carcinoma is true.

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All right.

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the correct answer is actually

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infiltrate you you were

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taking a lot of customoma is normally ER PR positive

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here. Very cute. Could it

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be positive could be negative? It's not often

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triple negative. It's not that common. Okay.

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And often they don't

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have the yeti kind of hearing is the one over the ESV

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cervical pathological exam. We

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normally performed to differentiate The

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Logical carcinoma from the doctor carcinoma.

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And then invasive lobular carcinoma.

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Can you spread to the abdomen and the pelvis

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when compared to the lobby customer?

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compared to the doctor carcinoma

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So let's just review this shrinking breasts.

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Closet about the diffuse infiltrating modular carcinoma

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as the video is a maintain that invasive orbital

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carcinoma can cause the loss of

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what you can hearing remember that it kind of hearing

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is one of the molecule can hold. What is

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the quality in fiber together in the breast if

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it delete that and then that

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the

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lobulous sales that can spread diffusely along

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the ecology in fibers.

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It will produce video will.

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Infiltrate this breast without producing magia

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decimal classical response like

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a local carcinoma. This is why

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it's a very sneaky. It's very hard to take it

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on the monogram or ultrasound.

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MRI is often performed because it were

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unkind down the MRI.

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And you will be surprised on MRI and additional meeting

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will be found.

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And if we just mentioned that invasive lobular cosmoma has

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a very unusual metastatic patterns.

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Sometimes the people may think is

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behave.

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Behave like it is all very or very

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cancer in a perotonin's bread.