RSNA 2013

Nov 30, 2013

Winding down with some coffee and continuing medical education credit is Dr. Satoshi Yabusaki from Sapporo, Japan.

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Images show a palpable mass in the left breast in a 55-year-old woman. (A) Mammography shows a 26-mm ill-defined mass with fine linear calcifications in the central portion of the left breast (arrows). (B) ultrasound shows a 23-mm hypoechoic mass with calcifications in the corresponding area accompanying palpability (between the arrows). (C) An axial, fat-saturated, contrast-enhanced T1-weighted MRI scan shows an 18-mm irregular heterogeneous enhancing mass in the left breast (arrows). After breast-conserving surgery, the final pathologic report confirmed a grade II estrogen receptor–negative, progesterone receptor–negative, human epidermal growth factor receptor 2–positive invasive ductal carcinoma. There was no lymphovascular invasion, and the resection margins were clear. The patient declined both adjuvant chemotherapy and radiation therapy due to psychologic distress. (D) 11 months later, surveillance ultrasound helped to detect a new 25-mm irregular hypoechoic mass at the 12-o’clock position in the left breast (arrows). A subsequent ultrasound-guided biopsy confirmed it as a recurrence of grade II invasive ductal carcinoma, maintaining the same receptor statuses. Images courtesy of the RSNA.
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