MedPix® Patient Chart - Case No: 9409 :: Imaging - Review Images

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History

Age: 38 :: Gender: woman

Patient History

38 y/o woman for screening mammogram.

Exam


Physical Exam and Laboratory

Unremarkable


Findings


Summary of Findings

Architectural distortion in the right upper outer breast with associated calcifications


Diffferential


Differential Diagnosis

-Infiltrating carcinoma
-Complex sclerosing lesion (radial scar)
-Fibrocystic change with sclerosing adenosis

-Post-surgical or traumatic scar (patient had no prior history of surgery or trauma to right breast)


Diagnosis


Case Diagnosis

Dx: Fibrocystic change with adenosis


Dx Confirmed by: Excisional biopsy

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Followup


Followup and Treatment

Routine annual mammogram

Discussion


Discussion for this Patient

A free-hand (anteroposterior) needle/wire location was used in this case. This is a more difficult technique that requires extrapolation of the lesion from a compressed mammogram to the breast in a natural, uncompressed state.

Some suggest increase risk of complications such as chest wall penetration (pneumothorax) with this technique (versus parallel to chest wall approach). This approach may also need several adjustments to get the needle/wire within 1 cm of the lesion


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Topic


Fibrocystic change, Breast

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FIBROCYSTIC CHANGE WITH SCLEROSING ADENOSIS: BREAST

Fibrocystic change is a common diagnosis in women from 30 to 50 years old. This condition tends to resolve with menapause.
Fibrocystic change is a proliferation of the terminal ducts, lobules and surrounding connective tissue with associated fibrosis.

The mammographic appearance is variable and can include: cysts, calcifications (clustered or regional), masses (well-defined to spiculated), or architectural distortion.

REFs


References and Supporting Materials

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:: PT: 9409 :: :: 2 questions

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History:
38 y/o woman for screening mammogram.

Exam:
Unremarkable

Findings:
Architectural distortion in the right upper outer breast with associated calcifications

Differential:
-Infiltrating carcinoma
-Complex sclerosing lesion (radial scar)
-Fibrocystic change with sclerosing adenosis

-Post-surgical or traumatic scar (patient had no prior history of surgery or trauma to right breast)

Diagnosis:
Fibrocystic change with adenosis
Confirmed by:Excisional biopsy

Treatment and Followup:
Routine annual mammogram

Discussion:
A free-hand (anteroposterior) needle/wire location was used in this case. This is a more difficult technique that requires extrapolation of the lesion from a compressed mammogram to the breast in a natural, uncompressed state.

Some suggest increase risk of complications such as chest wall penetration (pneumothorax) with this technique (versus parallel to chest wall approach). This approach may also need several adjustments to get the needle/wire within 1 cm of the lesion

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Case Contributor and Editor
Topic Author: Erik W. Bergman
Submitted by: Erik W. Bergman - Author Info
Case/Image Editor: Claudia E Galbo - Editor Info
Case Accepted: 2006-02-28 07:37:42-05 :: Revised: :: Submitted:
COW: 282 :: CME Start: 20060305 :: CME End: 20110417 :: CME Review Due: 20090305

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