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Architectural Distortion - Radiating Lines, Mass / Invasive Lobular Carcinoma (ILC)

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This is a 59-year-old female presenting with a left

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breast palpable abnormality, showing you, uh,

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full-field CC and MLO views of the left breast.

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We see our palpable BB marker, um, in the upper

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inner breast, probably approximately 11 o'clock.

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On these SM views, we can see some scattered

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round calcifications, which look typically benign.

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On the CC view, there's some suggestion of

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asymmetry here in the more medial breast,

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potentially corresponding with a palpable marker.

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And on the MLO view, we see this area

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here with some potential architectural

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distortion here in the upper breast, which

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might correspond to this palpable marker.

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We switch over to the DBT views.

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We'll scroll from the inferiorly

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to superiorly first.

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As we scroll through, she's got heterogeneously

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dense tissue, but if we stop about right

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here, we can see some associated architectural

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distortion and some potential mass here.

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Right now there's lots of radiating lines coming down,

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all directions here, going posteriorly, medially,

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actually laterally here, and this looks like

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it corresponds directly to the palpable finding.

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I'm gonna scroll back to where we

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thought this was the worst area.

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I'll leave that there for a moment.

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If we look at the MLO view,

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we can see, uh, that as we scroll from lateral

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to medial, we get to this point here. We can

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see a large area of architectural distortion

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and a mass, and we see our radiating lines

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here going out in almost all directions.

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Um, and this, uh, is clearly a true, uh, mass

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and architectural distortion finding, which

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warrants further workup with an ultrasound.

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Patient did go on and have an ultrasound.

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We see a large area, uh, at 11 o'clock, five

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centimeters from the nipple, which is heterogeneously,

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hypoechoic, angular, and indistinct margins,

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maybe a little bit of that hyperechoic halo, with

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posterior shadowing and some associated vascularity.

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This corresponds with the finding that

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we saw in the left breast at 11 o'clock on

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the mammogram with that area of distortion,

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and this is highly suspicious for mal—

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Said need clip from that side on the left side.

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Um, we can scroll through and you can see some

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areas that look like there's some potentially

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radiating lines coming out from, uh, this mass.

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And that's the distortion that

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we see on the mammogram as well.

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You can tell on the ultrasound it's

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a lot more difficult to appreciate

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distortion, um, but it's clearly evident.

Report

Faculty

Ryan W. Woods, MD, MPH

Assistant Professor of Radiology

University of Wisconsin School of Medicine and Public Health

Tags

Women's Health

Ultrasound

Tomosynthesis

Oncologic Imaging

Mammography

Breast

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