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Case number 10 history is screening.

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Okay, and now because Health cases are

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always notoriously hard on projections on

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a PowerPoint. I provided you with some

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additional images.

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and to be extra kind a few extra images

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So now go to the question and I'll scroll back so that

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once the question pops up so you can continue to look.

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Good. Hold on sorry you guys

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go.

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75% of course heterogeneous. 25%

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said Lucent no one said large

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Rod like and no encyclomorphic. I'm not going to give you the answer yet.

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Because I want you to answer the next question.

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And I'm happy to go back to the images again.

1:02

All right, and 50% of you said sexual

1:05

carcinomian say to virus for okay

1:08

and 50% skin counts. Let's go back to

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the case. So I want you to notice that the

1:14

calcifications are about 12 o clock in the

1:17

right breast here. They're very hard to see right. So

1:20

remember I was doing you guys a favor

1:23

by nagging those up because it's so hard to see and normally you can Max them

1:26

up yourself, but you want to judge.

1:29

If they're finer course based on the non-mags mammogram,

1:33

right? So these are really hard to see so

1:36

I wouldn't quite call these cores. I would think these are fine.

1:40

Then we mad them and we see they're all different shapes. So

1:43

I call these punctuation calcifications or

1:46

shrapnil calcification and so punctuation calcifications.

1:49

I call them that because if I look closely here

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and I think I like my next image even better down here. Okay.

1:55

This looks like a parentheses.

1:58

It's like a comma this looks like a period I think there's another comma here

2:01

it looks like a colon. So it looks

2:04

like you someone hit all the punctuation keys on the

2:08

on the keyboards. And so

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that's multiple different shapes and that's

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the definition of cleomorphic.

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And I also call them shrapnel calcification

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because it almost looks like a bomb goes off.

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And so if a bomb explodes and shrapnel goes all over the place. It's

2:25

in all different shapes and sizes. It's not uniform right and

2:28

it's a bomb a good thing or a bad thing. It's bad thing, right?

2:31

So that's why I remember this shrapnel calcifications all

2:34

different sizes of strap. No bad dcis. Okay, so

2:37

these are pleomorphic health education.

2:40

And the their caused by usually high

2:43

grade dcis with commute and necrosis and

2:46

again necrosis when things are benign. They tend to

2:49

push and grow very uniform and and look

2:52

very symmetrics when things

2:55

are malignant. There's infusion. There's necrosis. It's

2:58

a regular rate. And so so that's

3:01

what this is. So these would so I want

3:04

to go over the answer. So these are not large Rod like calcifications right large

3:07

Rod, like calcifications describe secretory

3:10

calcifications, and

3:13

they're usually emanating from the nipple. It's benign. It's caused by

3:16

plasma cell messeitis and usually see

3:19

them symmetric and again radiating from the nipple. We just talked

3:22

about the amorphic loosen Center calcifications is

3:25

a benign descriptor, right? So this is where you really need to know you're by

3:28

Red.

3:30

Loosen Center is a benign descriptor and these are those.

3:35

Don't don't or Cheerio calcifications where they're

3:38

around. They have a loosen Center. Usually if you

3:41

do tangential views, you can localize them to the skin, of course

3:44

heterogeneous. I know that is a confusing thing for plea

3:47

Market calcification that actually have get done this case many times.

3:50

I've actually never had the confusion from my participants before

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so now I'm going to learn to put another slide to show

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you guys. What a course at our genius calcification is in the answers so

3:59

that we can learn about that but they're much

4:02

easier to see much much easier to see and they almost look

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like developing popcorn calcifications. Okay, so

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definitely not it's fine. Feel more pick are more

4:11

fine. Okay, so you but both leomorphic and

4:14

chords heterogeneous are concerning descriptors, right? Whereas large

4:17

like and lose it are benign descriptors.

4:21

So this would be dcis which is a byrest for

4:24

skin calcification would be those loosen Center

4:27

and they would be a buyer ads too. Okay?