Breast cancer - temporal evolution

MLO view left breast 2010 with a second annotated view.

2013 images of the left breast with an annotated CC view.

LesionSolid IDC with spiculated marginsall the hallmarks of malignancy. BIRADS V lesion.

Whyshow a Doppler image of the lesion?

This lesion has a large vessel at 11 o'clock and avein a vein posteriorly deep to the lesion. On coring this lesion, approach and fire the gun form the right, not the left. Biopsy this lesion at 3 o'clock and miss the vessels anteriorly and posteriorly.

Developing carcinoma left breastBreast cancer - temporal evolution

The object of this case is not  unthinkingthe unthinking use of the  all seeing "retrospectoscopeall-seeing "retrospectroscope", an instrument has 6/6 vision on hindsight. The teaching point here is to allow you to look at a case and train your eye to observe and recall the spiculated "runners" that radiate from a small solid lesion. You can train your eye to spot the "runners" and lead it to the mass even in a dense breast. This is a skill that you can aquireacquire with practice and effort.

If you are reading mammograms in a busy noisy, distracting, overlit environment, you will miss these lesions most of the time. You need to review mammograms in an environment that allows you to concentrate on what you are doing. No phone.

Developing carcinoma left breast