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WORK UPS
Ultrasound
• method of choice for the differentiation of cysts from solid masses and for guidance in interventional procedures.
• Benign:– solid lesions with smooth or lobulated
margins that are sharply defined, with homogeneous hypoechoic contents and a horizontal orientation
• Malignant: – hypoechoic lesions with irregular and
poorly defined margins
the lesion is a fibroadenoma
CORE BIOPSY
– Gold standard for diagnosing breast mass
– procedure where a gauge needle ( 21 gauge) is passed through the skin to take a sample of tissue from a mass or lump.
– more invasive procedure than FNAB, as it involves a local anaesthetic.
WORK UPS in the ward
Dec’ 2010 – CORE BIOPSYRESULTS: Invasive Lobular Carcinoma
Lobular neoplasia involving adenosis.
Notice the black ink on perimeter of core indicating targeted calcifications. Microcalcification is present in acinus.
Chest X-ray
• to check and see whether the cancer has metastasize to the lungs
During treatment for breast cancer:• If a person has advanced breast cancer that has spread to
the lungs, a chest x-ray is used to check on how the disease is responding to treatment.
• For people who develop a fever during chemotherapy, chest x-rays are used to check for the presence of pneumonia.
• If a person experiences new shortness of breath in the first few months after radiation therapy, with or without a cough, to see if the radiation caused any inflammation of the lungs.
Bone scan
• nuclear scanning test that identifies new areas of bone growth or breakdown
• It can be done to evaluate damage to the bones, find cancer that has metastasized to the bones
• monitor conditions that can affect the bones BONE SCAN FINDINGS
Confirmed osteoblastic metastatic bone lesions that enhance on radionuclide bone scan
Work ups
February 1’ 11
Chest Xray• Normal results• Lung fields clear February 7’11
Bone Scan• No definite scintigraphic evidence of osseous
metastasis
Mammography
– process of using low-dose amplitude-X-rays to examine the human breast and is used as a diagnostic and a screening tool.
– early detection of breast cancerScreening: 40y/o every 1-2years 50 y/o once a year
– follow up exam of breast CA treatment
– follow up exam of the contralateral breast
Mammography
Malignant lesions tend to have irregular and (usually)
spiculated margins
Benign well-defined edges and a halo sign
Normal Fatty breast
IN OUR PATIENT
Assessment:Spiculated, high density mass, high suspicion of malignancy, left (s/p core biopsy – invasive lobular carcinoma)