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Solitary Mass - Malignancy

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

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presenting for a baseline screening mammogram.

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If we look at our image quality, um, this

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case looks like it has good image quality.

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Um, and right away we see something, uh,

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in the right, uh, breast here looking like

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it's an approximate subareolar, uh, location.

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Those a little bit closer.

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We'll first pull down the right CC view.

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

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it looks like probably a mass, which is

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irregular in shape, uh, spiculated margins or

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potentially associated architectural distortion.

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Um, and looks probably equal density in comparison

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to the rest of the fibroglandular density.

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We scroll through our DBT images, scroll

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through here, and we come to this point here.

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

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and architectural distortion really well.

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So we can see some spiculated margins here.

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These long distortions sort of coming out here, right?

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

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Um, certainly an abnormal finding

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that's gonna warrant some further out.

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We pull down the MLO view again, see a

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corresponding finding here in the subareolar

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

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

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

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these long, uh, areas of architectural distortion,

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so pulling in that tissue and

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giving that appearance in a central

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mass here, probably much smaller in size.

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Of course, it is difficult to

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provide measurements for this.

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

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measure the size and don't include this

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area of distortion, although you certainly

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wanna mention it to your technologist.

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

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mammogram and ultrasound, and on diagnostic,

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we can see that same area was seen on our spot

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compression views, uh, not too surprising.

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There didn't actually offer that much

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in addition, getting those particular views.

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And then all of a sudden we see a corresponding

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irregular hypoechoic mass, indistinct

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margin that's in corresponding shadow, a

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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

Tags

Women's Health

Ultrasound

Tomosynthesis

Oncologic Imaging

Mammography

Breast

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