IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Developing breast density - history of previous treated breast cancer

Case contributed by Garth Kruger , 31 Jan 2013
Diagnosis almost certain
Changed by Henry Knipe, 19 Nov 2018

Updates to Quizquestion Attributes

Question was added:
Do you agree that annual mammographic follow-up is indicated in a case of a previous breast carcinoma?
Answer was added:
Yes, unless the initial carcinoma was occult on mammogram in which case you would add ultrasound or MRI depending on which modality found it last time. If the lesion initially was not seen on a mammogram, chances are the same will be true for any follow-up malignancy.

Updates to Quizquestion Attributes

Question was changed:
1. Describe the role of BiradsBIRADS III in a screening programme. 2. Do you agree that annual mammographic ollow up is indicated in a case of a previous breast carcinoma?
Answer was changed:
1. It has none. There should be no option ina screening setting to choose BiradsBIRADS III as a management option. If a lesion is not BiradsBIARDS II, it is BiradsBIARDS IV. If the lesion worries you today, it will still worry you in 6 months even if it has not changed. Do not assume lesions that are stable are benign. 2. Yes, unless the initial carcinoma was occult on mammogram in which case you would add ultrasound or MRI depending on which modality found it last time. If the lesion initially was not seen on a mammogram, chances are the same will be true for any follow up malignancy.

Updates to Quizquestion Attributes

Question was added:
The reader calls this lesion BIRADS III and suggests 6 months follow up. Do you agree?
Answer was added:
In a patient with a previous IDC and a lesion that has developed, there is no place for BIRADS III. This lesion should be treated as a BIRADS IV lesion and is until proven otherwise, a cancer in the ipsilateral breast.

Updates to Study Attributes

Findings was changed:

Another in a series of cases to illustrate both pathology and management of breast pathology.

Post surgical-surgical parenchymal distortion is seen. Otherwise unremarkable study.

Images Changes:

Image Mammography (MLO) ( update )

Perspective was set to MLO.
Single Or Stack Root was set to .
Description was removed:
MLO view left breast 2009

Updates to Study Attributes

Modality was set to Mammography.
Caption was added:
One year follow-up
Images Changes:

Image Mammography (MLO) ( update )

Single Or Stack Root was set to .
Perspective was set to MLO.
Description was removed:
Left MLO view 2010.

Updates to Study Attributes

Modality was set to Ultrasound.
Findings was changed:

The reader calls this lesion Birads III and suggests 6 month follow upRounded hypoechoic mass. Do you agree?

In a patient with a previous IDC and a lesion that has developed, there is no place for Birads III. This lesion should be treated as a Birads IV lesion and is until proven otherwise, a cancer in the ipsilateral breast.

Images Changes:

Image Ultrasound ( update )

Single Or Stack Root was set to .
Description was removed:
Ultrasound image of the lesion seen on the mammogram.

Updates to Study Attributes

Modality was set to Mammography.
Caption was added:
Six months later
Images Changes:

Image Mammography (MLO) ( update )

Single Or Stack Root was set to .
Perspective was set to MLO.
Description was removed:
MLO image 6 months later.

Updates to Study Attributes

Findings was changed:

It is now a full year after the lesion appeared and was dubbed BiradsBIRADS III. The lesion is larger on mammogram.

Caption was added:
Six months later
Images Changes:

Image Mammography (MLO) ( update )

Perspective was set to MLO.
Single Or Stack Root was set to .
Description was removed:
MLO view left breast 6 months later.

Updates to Case Attributes

Title was changed:
Developing breast density in the left- history of previous treated breast of a patient with a previous carcinomacancer
Suitable For Quiz was set to .
Diagnostic Certainty was set to .

Systems changed:

  • Oncology

Updates to Link Attributes

Title was removed:
Developing density in the left breast of a patient with a previous carcinoma
Type was removed.
Visible was set to .

Updates to Primarylink Attributes

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.