Case 49 saga 2

The mass at 12:00 in the left breast does appear lobulated and almost spiculated on the medial slices. With washout on delayed images, this is suspicious for malignancy. Since the mass at 6:00 in the right breast had washout as well, is was biopsoed as well. The mass in the lower inner left breast corresponds to the known fibroadenoma, and has smooth margins and non-enhancing septae.

An ultrasound-guided biopsy was performed of these two additional masses:

Review of the images confirms that this mass does look more lobulated and irregular than the others. Wish I had biopsied that one in the first place...

Pathology reports fibroadenoma in the right breast at 6:00 and Infiltrating Ductal Carcinoma on the left at 12:00! But she's 29 and has multiple fibroadenomas, you scream! If I have to worry about cancer every time I see a fibroadenoma I'm going to go insane! Well, that is true. You just have to follow the rules. That is why we biopsy palpable masses, and why we look for 2-3 year stability!

This patient went on to have a left mastectomy, negative sentinel node biopsy, is doing well and gives us a big hug every time we see her.