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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
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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 BIOPSY RESULTS: Invasive Lobular Carcinoma Lobular neoplasia involving adenosis. Notice the black ink on perimeter of core indicating targeted calcifications. Microcalcificationis 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 cancer Screening: 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 Normal Fatty breast Benign well-defined edges and a halo sign
IN OUR PATIENT • Assessment: • Spiculated, high density mass, high suspicion of malignancy, left (s/p core biopsy – invasive lobular carcinoma)