0:00

Okay, so moving on to question number nine. There's

0:03

new calcification in the postalumpectomy oncoplastic

0:07

reduction. What is

0:10

the appropriate barat's assessment on these

0:13

on this calcification? So this

0:16

is by rats to benign finding

0:19

what we see is a rim calcification

0:22

with Associated fat and this

0:25

is classic for fat necrosis. Usually fat

0:28

necrosis occurs in the first two years of surgery

0:31

or radiation. If it

0:34

is, like let's say five six years unless it's

0:38

a very classic fat necrosis calcification.

0:41

I would you should have a low threshold

0:44

to biopsy those.

0:51

This is a companion case recently. It

0:54

was a screening callback at a from a

0:57

screening. This was right at the prior surgical site.

1:02

So here you could see if I

1:05

show you the other thing like here you could see there is

1:08

a little bit of hold on one second. There is

1:11

a little bit of fat.

1:14

You could see inside and so my

1:17

fellow was telling me that this could be fat necrosis. But

1:20

when you think carefully when you

1:23

look at it carefully, that's what I'm gonna do here. You

1:26

could see there's a

1:28

new density suggestive of

1:31

a mass surrounding this fat. And by

1:34

the way, this Distortion was it's supposed

1:37

surgical. It's always been there. So it was

1:40

supposed surgical distortion.

1:42

But there's this new density and you

1:45

could see these amorphous calcification extending anteriorly

1:48

towards the nipple.

1:53

So when you have both of these worries of features, you

1:56

should prompt that should

1:59

prompt a biopsy especially if you have Childs that

2:02

are ductal and extending to the nipple with the

2:05

exception of the large rod-like calcification.

2:08

Make sure you have low threshold to

2:11

biopsy. And in this case we biopsied and it

2:14

was invasive Dental carcinoma with dcis.