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This 58-year-old woman presents for a right breast

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cancer staging, and her known cancer is invasive

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ductal, grade one, ER/PR positive, HER2 negative.

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These are her low energy images.

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Uh, she has, uh, scattered fibroglandular densities.

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And on the right, we see a mass or,

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uh, focal asymmetry with a clip and a

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nipple inversion when we combine images.

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So we see an enhancing mass.

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But we also see, uh, this linear, uh, non-

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mass enhancement in the right outer breast.

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This is an incidental finding, and, uh, we can see it

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on both views, on both craniocaudal and MLO views.

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So we also happen to have, uh, DBT on this, uh,

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patient, and you can see that this linear non-

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mass enhancement actually corresponds to, um, a

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DBT finding — maybe a little focal asymmetry on DBT.

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Unless we saw something on recombined images, we

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probably would not think much about the DBT finding.

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But right now we can cross-correlate it.

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The good thing about having an option of, uh, doing a

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DBT — if you don't have a CM-guided biopsy, you can try

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to attempt to do a DBT-guided biopsy if you have to.

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So this is for MLO view.

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On the left we combine, on the right a DBT view.

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And again, you can see that there might be

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a little mass or focal enhancement on DBT,

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corresponding to our linear non-mass enhancement.

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So periareolar mass, uh, is obviously an irregular

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mass leading the nipple, and we decided to

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do a CM-guided biopsy of our incidental non-

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mass enhancement in the right outer breast.

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So on the top you see our,

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uh, combination SCV approach.

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So this was a big combined image

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on the left.

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We did the DBT, uh, also under the same compression.

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And obviously on the right there is a low-

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energy, and we cannot see anything at all.

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So we combine images.

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Can be used as a target in this case if needed.

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Probably DBT can be used for this

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little finding underlying it.

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But in this case, we actually did see enhancement

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on both angled paired targeting recombined

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images, so it was okay to use for targeting.

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So we did the CM-guided biopsy,

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and this is called pre-fire image.

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So we know that we are on target.

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So...

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On this image, you can see the biopsy clip.

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Obviously, after the procedure, the positioning

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is a little bit off, but we were pretty

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confident that we got the correct area, and it

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was, uh, invasive ductal cancer, grade one.

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So it was, uh, obviously a multicentric cancer

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in the right breast detected by CM. So the point

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of this one — so it was a presentation, uh, of a

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linear non-mass enhancement as an invasive cancer.