What is Your Diagnosis

Hematoma: A hematoma normally occurs in conjunction with breast surgery but may also develop after minimally invasive biopsies (see Fig. 12.7) and other injuries to the breast. In most cases the connection with the trauma is

Fig. 12.18 This is the relevant subsection of Mrs. Hansson's mammogram.

I Skin Alterations

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.

evident and indicative of the diagnosis. Beware, however, of injuries suddenly remembered after a lesion is found: patients may be in denial and understandably tend to look for nonmalignant causes of a lump in the breast.

Oil cyst: Fat necrosis may develop at the site of tumor resection and ultimately may turn into an oil cyst (see p. 274). Oil cysts are easy to differentiate from other lesions mammographically because of their fat-equivalent density (see Fig. 12.4e).

Skin alterations after surgery: The retraction of the skin and the scarring of the cutaneous and breast tissue may assume the mammographic appearance of a tumor recurrence. In addition, therapeutic radiation leads to skin thickening and the parenchyma may develop some radiation fibrosis; this makes mammographic evaluation of the treated breast extremely difficult (Fig. 12.19). Contrast-enhanced MRI of the breast may be of use in this situation and is being evaluated as an adjunct tool to mammography.

Recurrent carcinoma: The recurrence of a breast carcinoma is diagnosed mammographically mainly by the comparison of sequential postoperative examinations. Its appearance is not really different from what a primary tumor looks like (see Fig. 12.8).

I The Case of Trudy Hansson II

I The Case of Trudy Hansson II

Fig. 12.20 The breast MRI confirms the presence of a contrast-enhancing lesion in the suspicious region. There is little chance for this to be anything but a carcinoma. Fortunately, there are no associated additional malignant foci.
How To Reduce Acne Scarring

How To Reduce Acne Scarring

Acne is a name that is famous in its own right, but for all of the wrong reasons. Most teenagers know, and dread, the very word, as it so prevalently wrecks havoc on their faces throughout their adolescent years.

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