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Interesting Mammograms #1

Mammography is a vital tool used for screening & diagnosing breast lumps (benign & malignant). In this new thread, I will be sharing some interesting mammograms every week, which I see in my practice.

Case #1

Calcified Fibroadenoma in a 32 year old lady.

H/o lump in the left breast for the last 12 years. Not increasing in size & Painless.

X-ray mammography revealed an area of dense calficification (macrocalcification) at 9-10 o’ clock position.

Calcified Fibroadenoma

 

 

Case # 2: 

X-ray mammogram highlighting the difference between benign & malignant lymph nodes in the axilla.

History: 45 year old lady with an enlarging right breast lump x 4 months

On examination: 4×4 cm hard breast lump in the upper outer quadrant of the right breast with palpable axillary LN.

Mammogram showing the primary lesion (cancerous growth) in the right breast and malignant axillary LN on the right side (rounded LN with loss of fatty hilum).

Benign LN can be seen in the left axilla (with preserved fatty hilum).

Primary & nodes

 

The second mammography picture highlights the difference between malignant (right) & benign (left) lymph nodes in the axilla

Nodes

 

Information provided by:

Dr. Rohan Khandelwal

Consultant, Breast Oncosurgeon

W Pratiksha Hospital

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15 thoughts on “Interesting Mammograms #1

  1. Thanks.It will be very helpful and essential for understanding radiological difference between benign & malignant LN in mammography.

  2. Thanks for sharing. I am curious whether you tend to use lymphoscintygraphy for the better differentiation between benign and malignant LNs.

    • These mammograms have just been shared for teaching purposes. In node negative patients we use sentinel lymph node biopsy (combination of radio nucleotide and blue dye) but in patients where there is obvious lymph node enlargement on ultrasound, we carry out axillary dissection.

  3. One comment and one query :
    Firstly, I hope you have investigated the rest of the breast of the lady with obvious calcified FA. There is evidence of widespread microcalcification.
    Secondly, I wonder what was the result of histology /cytology from the left axillary lymph nodes?

    • Thank you for your comments sir. Yes…we noticed the micro calcifications as well and got a sonomammogram & MRI for her which was not suggestive of anything else other than the calcified lesion. Pt has been called after 3 months for a repeat clinical examination.
      2nd case…sonomammogram was suggestive of benign ln in the left axilla..largest measuring 1.2x1cm. No lesion noticed in the left breast. Fnac was s/o reactive changes on the left side.

  4. Sir i didnt understand the point loss or presence of fatty hilum… i mean coudnt appreciate it…can u plz explain it ltl more….

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