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Advanced Ultrasound Techniques for Differentiating Breast Masses and Interventional Guidance

This document outlines the use of ultrasound as the preferred method for differentiating cysts from solid masses and guiding interventional procedures. It explains the characteristics of benign and malignant lesions, core biopsy as a gold standard for diagnosing breast masses, and the significance of chest X-rays and bone scans in monitoring treatment response and metastasis. Emphasis is placed on mammography for early breast cancer detection, with protocol recommendations based on age. The findings for a specific patient case of invasive lobular carcinoma are included.

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Advanced Ultrasound Techniques for Differentiating Breast Masses and Interventional Guidance

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Presentation Transcript

  1. WORK UPS

  2. 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

  3. 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.

  4. 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.

  5. 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.

  6. 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

  7. Work ups February 1’ 11 Chest Xray • Normal results • Lung fields clear February 7’11 Bone Scan • No definite scintigraphic evidence of osseous metastasis

  8. 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

  9. Mammography Malignant lesions tend to have irregular and (usually) spiculated margins Normal Fatty breast Benign well-defined edges and a halo sign

  10. IN OUR PATIENT • Assessment: • Spiculated, high density mass, high suspicion of malignancy, left (s/p core biopsy – invasive lobular carcinoma)

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