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Case 08

Contributed by Jordana Phillips MD

Updated December 2021

71-year-old with history of right breast cancer treated with breast conservation therapy. Annual CEM was performed.

Instruction: Look at the images below and answer the question that follows.

Diagnostic CEM

To see RECOMBINED IMAGES: Click the recombined buttons

To MAGNIFY: Click         or press Control + Wheel Scroll

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>> Click for Prior Imaging

There is increasing density surrounding the surgical site in the right breast. This was not present on prior imaging. Close this section to continue to the rest of the case.

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>> Click for Diagnostic Mammogram

No additional diagnostic views were acquired. Close this section to continue to the rest of the case.

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>> Click for Diagnostic Ultrasound

Targeted ultrasound was performed. Irregular hypoechoic areas with indistinct margins were noted surrounding the scar, corresponding to enhancement seen on CEM.

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Question

What is the next step?

Annual exam

Breast MRI

Ultrasound-guided core biopsy

6-month follow-up

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