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This is a case of a 74-year-old woman who

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presented to us for staging of right breast cancer.

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It was invasive ductal cancer, grade one

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to two, ER-positive, HER2-negative.

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These are her low-energy images.

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You can see a mass with spiculated

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margins and the clip.

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She has some implanted recording devices, the

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cardiac monitoring devices in the left breast.

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These are recombined images.

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Uh, right away you can see that there are some

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artifacts around those, uh, implantable devices.

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For whatever reason, mostly on the craniocaudal view,

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I'm not quite sure why it's, but not so much on the

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lateromedial, but on the CC we see that. But it's

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uh, obviously, uh, an artifact, so we can ignore that.

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And on the right, there is an

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enhancing mass with high conspicuity.

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So we know that that's the cancer. But also,

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we see this something that's either vessel or

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maybe linear non-mass enhancement on the left.

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This is this area circled on the low

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energy images, and this is a close

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up actually on magnification views.

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You might be able to see that there is actually

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ductal distribution calcifications in that area,

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and this is what that linear mass, uh, non-mass

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enhancement corresponds to on the right, as expected.

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Uh, there is a sonographic mass at 12 to 1 o'clock.

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We already know, uh, that this is a cancer.

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But on the left, we ended up doing a stereotactic

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biopsy and it was ADH—intermediate

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grade, solid and cribriform pattern.

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So, again, to go back to, so these are

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calcifications, and these are recombined

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images with linear non-mass enhancement.

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So, uh.

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This case demonstrates two different

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enhancement patterns of cancer.

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So, a highly conspicuous mass on the

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right, enhancing mass, and rather lower

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conspicuity, linear non-mass enhancement of DCIS.

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Just remember again, that especially with

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calcifications, the lack of enhancement there

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should not prevent you from doing a biopsy,

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if the, uh, appearance of those

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specifications on low-energy images is—

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suspicious enough to biopsy.

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In this case, it just happened to

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be, uh, enhancing calcifications.