Presentation
Routine breast imaging on a client who had her breast prostheses removed 16 years before.
Patient Data
The small density on the scar was assumed to be part of the change related to the previous surgery.
The density is now actually larger than a year previously. In fairness workup should now have been done. Post surgical scarring does not enlarge with time.
The MLO view 2013 and the ultrasound show a lesion confirmed as an IDC on needle biopsy.
Hypoechoic mass with spiculations and posterior shadowing.
Case Discussion
Another case of time lapse mammography to illustrate the value of careful comparison with previous studies and why regular follow up mammograms are so important.
One of the reasons open breast biopsy fell into disrepute was that in many cases the post surgical change is not distinguishable from a carcinoma on mammography. This small cancer had developed in the surgical scar at 6 o'clock left breast. Another reason was we started to make sense of mammography.
30 years ago open, routine multiple breast biopsies were performed when a mass became clinically palpable. After multiple breast biopsies the degree of distortion of the breast parenchyma made any kind of imaging virtually useless.
Early diagnosis = improved survival and cosmetically acceptable results (all other factors being equal).