Image IQ [1] October 17, 2014 By Stamatia Destounis, MD, FACR [2] [3] [4] [5] Page 1 of 6
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[9] A 50-year-old patient presented for screening mammogram. Extremely dense breast tissue was noted. On mammography (a-b), a 1-cm spiculated mass (arrow) was identified within the left breast, best demonstrated on the lateral view (c). Ultrasound (d) demonstrated an 8-mm hypoechoic mass in the 10:00 position of the left breast and, in addition, ultrasound identified a 1.1-cm hypoechoic mass at the 1:00 position (e). A needle core biopsy of the 10:00 mass was performed resulting in a diagnosis of invasive ductal carcinoma. The patient was referred for breast magnetic resonance imaging (MRI) for extent of disease evaluation. Breast MRI (f) demonstrated a new enhancing mass in the contralateral breast. MRI of the ipsilateral breast (g) demonstrated two enhancing masses consistent with the two lesions identified on ultrasound. Biopsy of new lesion in the contralateral breast was recommended. Click on the images to enlarge. What's your diagnosis? Fibroadenoma Fat necrosis Intraductal papilloma Choices Invasive ductal carcinoma Vote Invasive ductal carcinoma 74% (926 votes) Fibroadenoma 11% (143 votes) Fat necrosis 7% (93 votes) Intraductal papilloma 7% (91 votes) Total votes: 1253 Answer: Invasive ductal carcinoma Page 3 of 6
Comment Needle core biopsy of the contralateral breast lesion was performed under MRI guidance revealing invasive ductal carcinoma. Discussion Despite the normal findings on the mammogram and physical exam of the contralateral breast, cancer in the contralateral breast can subsequently be detected in up to 10% of women. On average, MRI can detect 5% of occult breast carcinomas found in the contralateral breast in women with a newly diagnosed cancer. Reference Lehman, CD, Gastsonis, C, Kuhl, CK et al. MRI Evaluation of the Contralateral Breast in Women with Recently Diagnosed Breast Cancer. The New England Journal of Medicine. 2007;356; 1295-1303. if (typeof PollAnon == 'undefined') { var PollAnon = {}; } PollAnon.nid = 202009; A 50-year-old patient presented for screening mammogram. Extremely dense breast tissue was noted. On mammography (a-b), a 1-cm spiculated mass (arrow) was identified within the left breast, best demonstrated on the lateral view (c). Ultrasound (d) demonstrated an 8-mm hypoechoic mass in the 10:00 position of the left breast and, in addition, ultrasound identified a 1.1-cm hypoechoic mass at the 1:00 position (e). A needle core biopsy of the 10:00 mass was performed resulting in a diagnosis of invasive ductal carcinoma. The patient was referred for breast magnetic resonance imaging (MRI) for extent of disease evaluation. Breast MRI (f) demonstrated a new enhancing mass in the contralateral breast. MRI of the ipsilateral breast (g) demonstrated two enhancing masses consistent with the two lesions identified on ultrasound. Biopsy of new lesion in the contralateral breast was recommended. Click on the images to enlarge. What's your diagnosis? * Invasive ductal carcinoma * Fibroadenoma * Fat necrosis * Intraductal papilloma Vote Page 4 of 6
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Source URL: http://www.physicianspractice.com/breast-imaging/image-iq-contralateral-breast-after-cancer-diagno sis Links: [1] http://www.physicianspractice.com/image-iq [2] http://www.physicianspractice.com/authors/stamatia-destounis-md-facr [3] http://www.physicianspractice.com/sites/default/files/mlo_0.jpg [4] http://www.physicianspractice.com/sites/default/files/cc_0.jpg [5] http://www.physicianspractice.com/sites/default/files/llm.jpg [6] http://www.physicianspractice.com/sites/default/files/us_2.jpg [7] http://www.physicianspractice.com/sites/default/files/us1.jpg [8] http://www.physicianspractice.com/sites/default/files/mri_0.jpg [9] http://www.physicianspractice.com/sites/default/files/mri2.jpg Page 6 of 6