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In this case, we have a 55-year-old female

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who is presenting for a diagnostic mammogram

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after routine screening. On the screening

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exam, uh, a mass or masses were identified

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in the medial aspect of the right breast.

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We've obtained a CC, uh, spot compression views

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of the medial aspect of the right breast,

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as well as MLO spot compression views of

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the inferior aspect of the right breast.

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On the SMV, we can already see that, uh, there are,

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uh, some masses in this location, which correspond to

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the finding was identified on screening mammography.

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Enlarges here and scroll through the imaging stack.

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We can see that we're starting at the

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inferior aspect of the, uh, image stack.

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As we scroll through, right away we can

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see that we're at the location of our

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masses in the medial aspect of the breast.

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Again, we know these are close to the

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skin surface by seeing the cutaneous, uh,

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fat deposits, um, skin, uh, line here.

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And it's at the very inferior

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aspect of the image stack.

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If we scroll through just for confirmation, we can

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see that, um, there's another mass here in the skin.

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Uh, more superior aspect, um, but

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nothing, no other findings that we see.

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If we look over in the MLO view similarly.

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We see those masses and, um, if we start

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in the medial side, we can see that those

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masses appeared in the medial aspect.

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Of course, very close to the skin surface.

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Again, there are some associated tiny

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calcifications here, which have mostly a

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benign sort of appearance, a little bit

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roundish, maybe a little coarse heterogeneous.

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And as we scroll through the rest of the image

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stack, there's nothing else that looks concerning.

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We could look at the envelope view

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just for confirmation and to sort of

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verify where this is in relation to.

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We see that it's just below the nipple

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on the medial side of the breast.

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Um, so this would be very close to four

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o'clock, and we'd want to tell our, uh,

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sonographer to look in the four o'clock axis.

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Look very close to the skin surface,

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um, and see what you can find.

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If we look at the corresponding ultrasound

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in this case, we can see that, uh,

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two adjacent masses were identified.

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Um, they're very close to the skin

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surface, and they're in the right breast

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at four o'clock, pretty far from the nipple.

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Um, you might wonder if these are, uh, masses that

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are within the skin or slightly below the skin.

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And we can see here that the skin surface

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looks like it does dip down to get to

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the posterior aspect of these masses.

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Um, and if we scroll along even further here,

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we can see that this one looks like it's

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completely, entirely contained within dermis.

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And so therefore, these are, um, skin-associated cysts.

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Um, and we also know that the, uh,

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far medial breast or inferior breast are

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classic locations for skin-associated cysts.

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Um, but our tomosynthesis really helped us, uh,

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guide us to that direction, knowing where it was, uh,

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within the breast and how close to the skin surface.