Double recurrence of breast tumor at mastectomy site
Past history of right mastectomy and radiation therapy for breast cancer 7 years ago. She was referred for biopsy of a palpable lump in the mastectomy site.
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Two lesions were seen on ultrasound at the mastectomy site:
- an ill-defined, irregular, hypoechoic lesion
- a spiculated, hyperechoic lesion with posterior shadowing
Ultrasound-guided core biopsy of both lesions showed invasive ductal carcinoma.
Hyperechoic cancers are infrequent and reported in fewer than 0.8% of invasive and in situ ductal carcinoma. Interestingly, hyperechoic lesions occur 10 times more frequently in infiltrating lobular carcinoma than infiltrating ductal carcinoma.