Breast cancer with metastasis (PET-CT)

Case contributed by Dalia Ibrahim
Diagnosis almost certain

Presentation

Recently discovered right breast mass. Biopsy showed invasive ductal carcinoma. For initial staging.

Patient Data

Age: 55 years
Gender: Female

PET-CT

Nuclear medicine

Increased FDG uptake by multiple right breast mass lesions, the most active at the UOQ with SUV max 15. Associated with diffuse breast edema and skin thickening.

Increased FDG uptake by multiple enlarged right axillary, right internal mammary, and right infra-clavicular lymph nodes.

Diffuse increased patchy FDG uptake with prominent multifocal FDG avid bi-lobar hypodense hepatic focal lesions at segments VIII, IV, and VI with SUV max 6 at the former.

Increased FDG uptake by small subtle sclerotic osseous lesions at both proximal femoral shafts with SUV max 5.3 on the right side. Increased FDG uptake by the left D10 costovertebral junction with no underlying CT correlates, likely degenerative.

Case Discussion

Pathologically proven case of right breast cancer with nodal, hepatic, and osseous deposits.

PET-CT easily detected subtle osseous metastasis.

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