0:01

So with that in mind, I wanna, um, next show a case of, um,

0:05

suspicious calcification.

0:06

So here are magnification views of grouped course heterogeneous

0:11

calcifications in the upper outer left rest. So

0:18

unlike all of the other cases I've shown, calcific uh,

0:20

calcifications are best visualized on ma um, on magnification views.

0:24

The tomosynthesis is not typically helpful in evaluating them,

0:30

but, um, we did do the bi this biopsy using tomosynthesis guidance.

0:35

So similar to the other cases,

0:37

we have our initial scout image where we take a tomosynthesis, um,

0:43

a set of tomosynthesis images through the area. Um, here are our calcifications.

0:49

Uh, it's important to,

0:51

to scroll above and below the area that you're intending to biopsy to make sure

0:55

there's not a vessel in the way. And that's, um,

0:56

something that's very helpful with tomosynthesis that you're able to do that to

1:01

see for sure that whether or not there are biopsies above and below the finding.

1:07

Here's our pre-fire image and I see my

1:12

biopsy device lined up just in front of those calcifications,

1:15

so I'm making sure that they didn't move when I did my, um,

1:18

numbing medicine and placed my biopsy device in.

1:30

After I took the samples, we place a biopsy clip.

1:35

Here's the biopsy clip. We see again, it's right,

1:37

it's lined up exactly where those calcifications had been.

1:40

I pull back my needle a little bit to make sure to see separation between the

1:44

biopsy clip and the biopsy needle. We

1:49

biopsy calcifications while we're still in the room with the patient.

1:52

We take a stereo, a, um,

1:54

specimen radiograph to confirm that the oin f calcifications have been removed

1:59

in order to come up with a a definite answer.

2:01

So here's our specimen radiograph showing, uh,

2:03

representative calcifications in the specimen. And,

2:08

um, this,

2:09

this did represent ductal carcinoma in situ grade two to three out of three.

2:15

Um, so in in summary, uh,

2:18

digital breast tomosynthesis has really changed breast imaging in the past, uh,

2:22

decade or a little bit more than a decade now. Um,

2:25

we see improved recall rate and improved cancer detection rate,

2:28

and we're also able to biopsy findings using tomosynthesis guidance,

2:32

which is very exciting. And this is, um, more of an evolving area.