Upcoming Events
Log In
Pricing
Free Trial

Normal Findings - Palpable Lump Focal Fibroglandular Tissue

HIDE
PrevNext

0:01

Alright. In this case, um, I'm showing images of the right

0:04

breast in a 48-year-old woman who presented with a

0:09

palpable abnormality in the upper outer right breast.

0:12

At our institution, we use a small BB

0:15

marker to, uh, denote palpable findings.

0:21

And when we look at these two views,

0:22

um, we acquire a right CC view.

0:25

Uh, we get a CC spot view

0:27

over the palpable abnormality.

0:29

Full field MLO view, MLO spot over the

0:32

abnormality, and then, um, an ML view as well.

0:38

So if we switch over to the DBT slices, moving

0:43

from inferior to superior and focusing really

0:47

mostly on the area of the palpable abnormality.

0:50

But of course, in the end I'll

0:51

look at all the breast tissue.

0:52

Um.

0:53

For the purposes of this, we'll focus mainly on

0:56

where the palpable marker is, and we can see that

0:57

that comes into view about here, um, somewhere

1:01

in the middle of the DBT stack. And we look

1:03

underneath or sort of deep to that palpable marker

1:05

and try to evaluate whether there's anything

1:07

that might correspond to that palpable finding.

1:11

I don't see anything in particular in this view.

1:12

There is some, uh, heterogeneously dense

1:15

breast tissue here underlying. Perhaps

1:18

that's something that she's feeling.

1:20

At this point, I would switch over

1:21

to the, uh, MLO view and look again.

1:25

Here again, we can see that our, uh, palpable

1:27

marker's on the lateral aspect of the breast.

1:30

We can see it most best, this

1:32

very far, um, lateral aspect.

1:35

And we know we're already there

1:36

because we have our scroll bar.

1:38

As we scroll nearby to that, we see that this,

1:41

again, this focal fibrous tissue comes into a

1:44

little bit better and view, but of course, we'll

1:46

look through the whole image stack to see if

1:47

there's something else that might stand out.

1:49

Now, in patients with palpable findings,

1:51

you wanna make sure that you look not just

1:53

superficially, but sort of also deep, right?

1:55

Patients, they perceive the feeling of, uh, the

1:58

palpable finding, of course, somewhere on the skin,

2:00

but that finding can be anywhere in the breast.

2:04

So already I think I'm a little bit suspicious

2:06

that what this patient's feeling is probably

2:08

just this fibrous tissue, but let's pull down

2:11

the spot compression views just to make sure

2:13

that we're not missing anything deeper in there.

2:15

And on the synthesized views, we can see that

2:17

that area again stands out a little bit, and

2:19

it's nearby, um, where that palpable marker is.

2:23

We'll switch over to the DBT views

2:25

and scroll through these as well.

2:28

Again, as we're looking through, we're looking

2:30

here to see if there's some sort of mass

2:31

or something hidden in this area that might

2:33

correspond to what this patient is feeling.

2:36

We might notice that a little bit of this

2:37

glandular tissue does sort of rise up towards

2:39

the skin surface, and perhaps that's the

2:41

superficial component that she's feeling.

2:44

As we scroll through here, we don't really

2:45

see anything that stands out as a distinct

2:47

mass or something that might be, um,

2:49

different, um, from just normal breast tissue.

2:53

Now, based on this, of course, we would send

2:54

the patient to ultrasound, and I'm not gonna

2:56

show you those images because it showed just

2:57

normal, uh, dense fibroglandular tissue.

3:00

But in the combination of these exams, including

3:02

the mammogram and the ultrasound, we can

3:04

be very confident that what this patient is

3:06

feeling is just some focal glands or tissue.

3:09

She happened to feel that, you know, maybe

3:11

perhaps feels different to her, but, um, but is,

3:14

um, wholly normal and nothing to worry about.

3:17

So we can, uh, reassure her and send her back to

3:20

her physician just to keep an eye on this over time.

3:22

And then also just recommend

3:23

routine screening at this point.

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

© 2025 Medality. All Rights Reserved.

Privacy ChoicesImage: Privacy ChoicesContact UsTerms of UsePrivacy Policy