Interactive Transcript
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This is a 62-year-old woman who
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presented, uh, to us for screening, uh,
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within one of our research protocols.
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And for her, this happened to be her baseline CEM
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and baseline DBT, digital breast tomosynthesis.
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She happened to have multiple prior
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mammograms, but none of them were done with
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DBT, and none of them were done with CEM.
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This is her low energy mammogram.
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And right here, we can see that on CC,
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on the craniocaudal view, there is
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some asymmetry in the central breast.
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When we do our contrast-enhanced
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mammography on the recombined images,
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there's definitely non-mass enhancement, uh,
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at least non-mass enhancement at 12 o'clock on the left.
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It's pretty asymmetric.
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It's at least, it's moderate
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conspicuity and definitely jumps at you.
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So on the left, it's a low energy
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image. In the middle is the recombined
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image. On the right, it's a DBT image.
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And on the DBT, we definitely see
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some kind of architectural distortion
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there, so it looks pretty suspicious.
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However, looking back on prior
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2D mammograms,
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she always had some kind of asymmetry there.
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There was no prior DBT to compare the
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distortion part of it, but the asymmetry
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has been there for several years at least.
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But now we know that there is a distortion, there is
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enhancement, so we are definitely concerned about it.
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We went for an ultrasound.
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Found this kind of, uh, mixed, uh, echogenicity,
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rather hyperechoic maybe, uh, or slightly
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hypoechoic mass with indistinct margins.
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We believe that this corresponded to
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our mammographic finding, and we ended up
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doing an ultrasound-guided biopsy of it.
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And then, as you can see, the clip
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is exactly in the area of concern.
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And it was a minimal usual ductal hyperplasia,
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apocrine metaplasia, minimal fat necrosis.
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She did not report any history of trauma.
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The point is it was stable on the images, but
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it was enhancing, so we ended up biopsying it.
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It was a false-positive DBT and
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recombined images, uh, false-positive.
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You definitely will encounter cases like that.
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It's very hard to dismiss them on the first
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CEM, but just know that false-positives
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like that exist and are not infrequent.
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And just for you to notice, in the left breast, in
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the upper outer breast, there is a skin mass.
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It's one of those, uh, cutaneous
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hemangiomas, but the larger one. It has
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been stable on multiple prior images.
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So...
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Right here, you can see an enhancing
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mass bright on the skin surface.
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So another example of an enhancing cutaneous mass.
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