Carcinoma right breast

Case contributed by Garth Kruger , 30 May 2014
Diagnosis certain
Changed by Henry Knipe, 11 Nov 2018

Updates to Case Attributes

Age changed from 53 years to 55 years.
Body was changed:

In general, as a personal preference, I preferThis lesion was later to keep mag views for microcalcifications and additional mammographic views (ML and rolled CC) for parenchymal asymmetries. Many will differ I knowbe confirmed IDC of the right breast.

This case illustrates why.

I am never sure on the mag view if I actually see the lesion or if it is/ not in the field of view. This is specially true of dense breasts; its sometimes very difficult to orientate yourself exactly as to position. This is a big problem in larger breasts. Looking at the mag view above, I think the tech is about right in the positioning. I am no nearer an answer after the trouble of the mag view than before. If so, why do it .. ?

Old school radiologists used to say anecdotally that you could compress a cancer "away". There is not proof of this as far as I know. But look at the mag view again: note how much relatively denser the surrounding tissue is compared with the compressed tissue centrally....

If you are going to use mag views for parenchymal asymmetry, do so thoughtfully and carefully. In my experience its, it is simpler quicker and easier all round to simply do rolled CC and ML views in these cases and then go on to the ultrasound.

  • -<p>In general, as a personal preference, I prefer to keep mag views for microcalcifications and additional mammographic views (ML and rolled CC) for parenchymal asymmetries. Many will differ I know.</p><p><span style="line-height:1.6em">This case illustrates why.</span></p><p><span style="line-height:1.6em">I am never sure on the mag view if I actually see the lesion or if it is/ not in the field of view. This is specially true of dense breasts; its sometimes very difficult to orientate yourself exactly as to position. This is a big problem in larger breasts. Looking at the mag view above, I think the tech is about right in the positioning. I am no nearer an answer after the trouble of the mag view than before. If so, why do it .. ?</span></p><p><span style="line-height:1.6em">Old school radiologists used to say anecdotally that you could compress a cancer "away". There is not proof of this as far as I know. But look at the mag view again: note how much relatively denser the surrounding tissue is compared with the compressed tissue centrally ....</span></p><p><span style="line-height:1.6em">If you are going to use mag views for parenchymal asymmetry, do so thoughtfully and carefully. In my experience its simpler quicker and easier all round to simply do rolled CC and ML views in these cases and then go on to the ultrasound.</span></p>
  • +<p>This lesion was later to be confirmed IDC of the right breast.</p><p>I am never sure on the mag view if I actually see the lesion or if it is not in the field of view. This is specially true of dense breasts; its sometimes very difficult to orientate yourself exactly as to position. This is a big problem in larger breasts. Looking at the mag view above, I think the tech is about right in the positioning. I am no nearer an answer after the trouble of the mag view than before. If so, why do it?</p><p>Old school radiologists used to say anecdotally that you could compress a cancer "away". There is not proof of this as far as I know. But look at the mag view again: note how much relatively denser the surrounding tissue is compared with the compressed tissue centrally...</p><p>If you are going to use mag views for parenchymal asymmetry, do so thoughtfully and carefully. In my experience, it is simpler quicker and easier all round to simply do rolled CC and ML views in these cases and then go on to the ultrasound.</p>

Updates to Quizquestion Attributes

Question was changed:
You sample this lesion and the histology comes back fibrocystic change. What do you do?

Updates to Quizquestion Attributes

Question was added:
The radiologist working up the case chooses to do a mag view instead of rolled CC and ML views. Look at this image carefully. Thoughts?
Answer was added:
In general, as a personal preference, I prefer to keep mag views for microcalcifications and additional mammographic views (ML and rolled CC) for parenchymal asymmetries. Many will differ, I know.

Updates to Study Attributes

Findings was changed:

This is the later to be confirmed IDC of the right breast. Tall as broad, sharp angles, short lobulated margins. Its not a benign lesion in anyone's book. You will always sample this lesion.

Updates to Study Attributes

Findings was changed:

The radiologist working upPersistent density on the case chooses to do a mag view instead of rolled CC and ML views. Look at this image carefully. Thoughts ?

Updates to Study Attributes

Modality was set to Annotated image.
Findings was added:

Abnormal new density centrally medial (arrow).

Images Changes:

Image Annotated image (CC) ( update )

Description was removed:
annotated image

Image 1 Annotated image (CC) ( update )

Position was set to .

Updates to Study Attributes

Caption was removed:
Another in the series of cases to illustrate potential pitfalls in workup of a mammographic abnormality.

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