Post surgical scarring left breast

Case contributed by Dr Garth Kruger

Presentation

Routine breast imaging on a client who had her breast prostheses removed 16 years before.

Patient Data

Age: 65
Gender: Female
Modality: Mammography

The small density on the scar was assumed to be part of the change related to the previous surgery.

One year follow-up

Modality: Mammography

The density is now actually larger than a year previously. In fairness workup should now have been done. Post surgical scarring does not enlarge with time.

Three year follow-up

Modality: Mammography

The MLO view 2013 and the ultrasound show a lesion confirmed as an IDC on needle biopsy.

Modality: Ultrasound

Hypoechoic mass with spiculations and posterior shadowing. 

Case Discussion

Another case of time lapse mammography to illustrate the value of careful comparison with previous studies and why regular follow up mammograms are so important.

One of the reasons open breast biopsy fell into disrepute was that in many cases the post surgical change is not distinguishable from a carcinoma on mammography. This small cancer had developed in the surgical scar at 6 o'clock left breast. Another reason was we started to make sense of mammography.

30 years ago open, routine multiple breast biopsies were performed when a mass became clinically palpable. After multiple breast biopsies the degree of distortion of the breast parenchyma made any kind of imaging virtually useless. 

Early diagnosis = improved survival and cosmetically acceptable results (all other factors being equal).

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Case Information

rID: 23904
Case created: 17th Jul 2013
Last edited: 31st Mar 2016
System: Breast
Inclusion in quiz mode: Included

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