IDC and DCIS left breast

Case contributed by Dr Garth Kruger

Presentation

A 65 year old woman is referred for screening.

Patient Data

Age: 65
Gender: Female

A 66 year old woman with two sisters with breast CA and no previous breast imaging.

Modality: Mammography

On the initial study there is a group of heterogenous microcalcifications inferiorly in the left breast. Mag views included; they are highly suggestive of DCIS. Confirmed on stereotactic biopsy.

But if you look carefully a spiculated density is also present superiorly in the left breast (see annotated image)

Modality: Ultrasound

The ultrasound images are of the IDC. The lesion was confirmed as an IDC on needle bx. The second image shows Kopans wire localisation pre surgery. Note teh beam "tilt" of the image. Its a handy feature if your machine has it. It keeps the beam tangential to the thin wire. 

Modality: Mammography

The patient is back for imaging one year later. The post surgical scaring is seen in the upper outer qudrant. The DCIS was removed by local excision. So far so good.

Modality: Mammography

18 months later the left breast shows widespread calcifications form DCIS. Biopsy proven. Mag views are included.

Case Discussion

After the initial surgery for IDC and DCIS left breast the patient refused radiation and tamoxifen therapy. Recurrence of the DCIS in the left breast was not treated at the patient's instruction.

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Case Information

rID: 27355
Case created: 31st Jan 2014
Last edited: 13th Mar 2016
System: Breast
Inclusion in quiz mode: Included

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