0:01

In this case, we have a 50-year-old female

0:02

presenting for a baseline screening mammogram.

0:07

If we look at our image quality, um, this

0:10

case looks like it has good image quality.

0:13

Um, and right away we see something, uh,

0:15

in the right, uh, breast here looking like

0:18

it's an approximate subareolar, uh, location.

0:22

Those a little bit closer.

0:24

We'll first pull down the right CC view.

0:29

And right away on this SMV we can see, um,

0:32

it looks like probably a mass, which is

0:34

irregular in shape, uh, spiculated margins or

0:37

potentially associated architectural distortion.

0:39

Um, and looks probably equal density in comparison

0:42

to the rest of the fibroglandular density.

0:45

We scroll through our DBT images, scroll

0:48

through here, and we come to this point here.

0:50

We can see those, uh, fine spiculations, uh,

0:53

and architectural distortion really well.

0:56

So we can see some spiculated margins here.

0:58

These long distortions sort of coming out here, right?

1:01

Giving that kind of pulled in or scar-like appearance.

1:04

Um, certainly an abnormal finding

1:06

that's gonna warrant some further out.

1:08

We pull down the MLO view again, see a

1:11

corresponding finding here in the subareolar

1:13

uh, right breast, maybe an anterior to middle depth.

1:19

And if we scroll through the, uh, DBT slices again,

1:22

uh, and stop here about in the middle, we can see

1:25

these long, uh, areas of architectural distortion,

1:28

so pulling in that tissue and

1:29

giving that appearance in a central

1:32

mass here, probably much smaller in size.

1:35

Of course, it is difficult to

1:36

provide measurements for this.

1:37

Um, I'd say for the most part people probably

1:39

measure the size and don't include this

1:42

area of distortion, although you certainly

1:43

wanna mention it to your technologist.

1:47

Um, the patient, uh, did go on to get, uh, diagnostic

1:50

mammogram and ultrasound, and on diagnostic,

1:55

we can see that same area was seen on our spot

1:57

compression views, uh, not too surprising.

2:00

There didn't actually offer that much

2:02

in addition, getting those particular views.

2:05

And then all of a sudden we see a corresponding

2:07

irregular hypoechoic mass, indistinct

2:10

margin that's in corresponding shadow, a

2:12

subsequently biopsy, and was an invasive lobular carcinoma.

Solitary Mass - Malignancy

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0:01

In this case, we have a 50-year-old female

0:02

presenting for a baseline screening mammogram.

0:07

If we look at our image quality, um, this

0:10

case looks like it has good image quality.

0:13

Um, and right away we see something, uh,

0:15

in the right, uh, breast here looking like

0:18

it's an approximate subareolar, uh, location.

0:22

Those a little bit closer.

0:24

We'll first pull down the right CC view.

0:29

And right away on this SMV we can see, um,

0:32

it looks like probably a mass, which is

0:34

irregular in shape, uh, spiculated margins or

0:37

potentially associated architectural distortion.

0:39

Um, and looks probably equal density in comparison

0:42

to the rest of the fibroglandular density.

0:45

We scroll through our DBT images, scroll

0:48

through here, and we come to this point here.

0:50

We can see those, uh, fine spiculations, uh,

0:53

and architectural distortion really well.

0:56

So we can see some spiculated margins here.

0:58

These long distortions sort of coming out here, right?

1:01

Giving that kind of pulled in or scar-like appearance.

1:04

Um, certainly an abnormal finding

1:06

that's gonna warrant some further out.

1:08

We pull down the MLO view again, see a

1:11

corresponding finding here in the subareolar

1:13

uh, right breast, maybe an anterior to middle depth.

1:19

And if we scroll through the, uh, DBT slices again,

1:22

uh, and stop here about in the middle, we can see

1:25

these long, uh, areas of architectural distortion,

1:28

so pulling in that tissue and

1:29

giving that appearance in a central

1:32

mass here, probably much smaller in size.

1:35

Of course, it is difficult to

1:36

provide measurements for this.

1:37

Um, I'd say for the most part people probably

1:39

measure the size and don't include this

1:42

area of distortion, although you certainly

1:43

wanna mention it to your technologist.

1:47

Um, the patient, uh, did go on to get, uh, diagnostic

1:50

mammogram and ultrasound, and on diagnostic,

1:55

we can see that same area was seen on our spot

1:57

compression views, uh, not too surprising.

2:00

There didn't actually offer that much

2:02

in addition, getting those particular views.

2:05

And then all of a sudden we see a corresponding

2:07

irregular hypoechoic mass, indistinct

2:10

margin that's in corresponding shadow, a

2:12

subsequently biopsy, and was an invasive lobular carcinoma.

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

Solitary Mass - Malignancy