0:00

This is a 77-year-old female

0:02

presenting for a screening mammogram.

0:06

You can see that the image quality

0:08

is sort of okay in this situation.

0:11

On the left side, uh, we have a good

0:14

CC exam and a decent MLO exam showing

0:17

the pectoralis muscle extending down to

0:19

the level of nipple. On the right side,

0:21

the exam looks like it's a little more difficult.

0:23

The CC, um, overall depth is a little short.

0:28

Um, and we don't see very much axillary muscle in the MLO.

0:32

Is likely related to the fact that the patient

0:34

has surgery, uh, on that side, and it's

0:36

compatible with her clinical history of

0:38

the prior lumpectomy in the right breast.

0:41

We can verify that clinical history by

0:42

looking at the imaging findings where you see

0:44

multiple surgical clips and an area of prior

0:47

surgery with a little bit of fat necrosis.

0:49

You see that same finding here on the right

0:51

breast with multiple surgical clips, an area of

0:53

necrosis, and probably some surgical changes within

0:56

the breast itself as we scroll through, um, the DBT

1:01

slices. You again see those same imaging findings.

1:05

Um, you might see some architectural distortions

1:07

associated with her surgery, potentially

1:09

something missing here, um, or this location

1:13

here with these certain radiating lines.

1:15

Now we also noticed that she has some skin

1:17

thickening, um, this sort of periareolar region and

1:20

inner medial, uh, aspect of the right breast.

1:24

We see those same findings here.

1:25

Uh, MLO view with more skin thickening

1:28

here, the inferior aspect of the breast, and

1:31

then the skin within this skin fold here.

1:32

This looks quite thickened as well.

1:34

All of these findings through the surgical finding

1:36

of clips and the architectural distortion, even

1:39

potentially this sort of increased parenchymal

1:42

sort of thickening appearance in the breast,

1:43

it's all normal for post-surgical patients

1:46

who've had previous radiation therapy.

1:49

This can all be considered benign

1:50

and just recommend routine screening.

Skin Thickening - Prior Lumpectomy, Post Radiation

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0:00

This is a 77-year-old female

0:02

presenting for a screening mammogram.

0:06

You can see that the image quality

0:08

is sort of okay in this situation.

0:11

On the left side, uh, we have a good

0:14

CC exam and a decent MLO exam showing

0:17

the pectoralis muscle extending down to

0:19

the level of nipple. On the right side,

0:21

the exam looks like it's a little more difficult.

0:23

The CC, um, overall depth is a little short.

0:28

Um, and we don't see very much axillary muscle in the MLO.

0:32

Is likely related to the fact that the patient

0:34

has surgery, uh, on that side, and it's

0:36

compatible with her clinical history of

0:38

the prior lumpectomy in the right breast.

0:41

We can verify that clinical history by

0:42

looking at the imaging findings where you see

0:44

multiple surgical clips and an area of prior

0:47

surgery with a little bit of fat necrosis.

0:49

You see that same finding here on the right

0:51

breast with multiple surgical clips, an area of

0:53

necrosis, and probably some surgical changes within

0:56

the breast itself as we scroll through, um, the DBT

1:01

slices. You again see those same imaging findings.

1:05

Um, you might see some architectural distortions

1:07

associated with her surgery, potentially

1:09

something missing here, um, or this location

1:13

here with these certain radiating lines.

1:15

Now we also noticed that she has some skin

1:17

thickening, um, this sort of periareolar region and

1:20

inner medial, uh, aspect of the right breast.

1:24

We see those same findings here.

1:25

Uh, MLO view with more skin thickening

1:28

here, the inferior aspect of the breast, and

1:31

then the skin within this skin fold here.

1:32

This looks quite thickened as well.

1:34

All of these findings through the surgical finding

1:36

of clips and the architectural distortion, even

1:39

potentially this sort of increased parenchymal

1:42

sort of thickening appearance in the breast,

1:43

it's all normal for post-surgical patients

1:46

who've had previous radiation therapy.

1:49

This can all be considered benign

1:50

and just recommend routine screening.

Report

Faculty

Ryan W. Woods, MD, MPH

Assistant Professor of Radiology

University of Wisconsin School of Medicine and Public Health

Lesson

Pre-Course Activities

Lesson

Introduction to Tomosynthesis

Lesson

Approach to Interpretation and Lesion Localization

Lesson

Normal Imaging Findings

Lesson

Asymmetries and Masses

Lesson

Gynecomastia

Lesson

Fat-containing Lesions

Lesson

Architectural Distortion

Lesson

Calcifications

Lesson

Associated Findings

Lesson

Postsurgical Findings

Skin Thickening - Prior Lumpectomy, Post Radiation