The Case of Trudy Hansson I

Fig. 12.19 This breast is edematous and dense after radiation therapy. Recurrent breast cancer is difficult to exclude on a conventional mammogram under these circumstances.

I Galactography: Normal Findings

I Galactography: Normal Findings

Galactogram

Fig. 12.21 This galactogram is completely normal. The ducts can be followed up to the mamilla; there are no cysts, no dilatations, no filling defects; and there is no abrupt termination of filling. In some women, fluid can be gently squeezed out of the ducts with just a little compression during the clinical examination. This is a normal phenomenon—even nonlactating breasts secrete minimal amounts of fluid, which are reabsorbed by the ductal epithelium.

Fig. 12.21 This galactogram is completely normal. The ducts can be followed up to the mamilla; there are no cysts, no dilatations, no filling defects; and there is no abrupt termination of filling. In some women, fluid can be gently squeezed out of the ducts with just a little compression during the clinical examination. This is a normal phenomenon—even nonlactating breasts secrete minimal amounts of fluid, which are reabsorbed by the ductal epithelium.

• Diagnosis: Hannah does not really believe that the abnormality on Mrs. Hansson's radiographs represents a hematoma more than a year after surgery. The density of the lesion is too high to consider an oil cyst. A scar is possible and pretty difficult to differentiate from a recurrence. The only other mammogram available is the pre-operative film. Dr. Skywang decides to get an MRI of the breast because it is more or less the only modality that can exclude a recurrence in this case (Fig. 12.20). The result of the MRI is highly suggestive of a tumor recurrence. Poor Trudy Hansson is going to go through it all over again.

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