First AD

Second AD

A 50-year-old patient presented for screening mammogram. Extremely dense breast tissue was noted.

), a 1-cm spiculated mass (arrow) was identified within the left breast, best demonstrated on the lateral view (

) demonstrated an 8-mm hypoechoic mass in the 10:00 position of the left breast and, in addition, ultrasound identified a 1.1-cm hypoechoic mass at the 1:00 position (

). A needle core biopsy of the 10:00 mass was performed resulting in a diagnosis of invasive ductal carcinoma. The patient was referred for breast magnetic resonance imaging (MRI) for extent of disease evaluation. Breast MRI (

) demonstrated a new enhancing mass in the contralateral breast. MRI of the ipsilateral breast (

) demonstrated two enhancing masses consistent with the two lesions identified on ultrasound. Biopsy of new lesion in the contralateral breast was recommended.


Needle core biopsy of the contralateral breast lesion was performed under MRI guidance revealing invasive ductal carcinoma. 


Despite the normal findings on the mammogram and physical exam of the contralateral breast, cancer in the contralateral breast can subsequently be detected in up to 10% of women. On average, MRI can detect 5% of occult breast carcinomas found in the contralateral breast in women with a newly diagnosed cancer.  


Lehman, CD, Gastsonis, C, Kuhl, CK et al. MRI Evaluation of the Contralateral Breast in Women with Recently Diagnosed Breast Cancer.  

Mammography

Ultrasound

News

50-year-old patient presented for screening mammogram. Extremely dense breast tissue was noted. 

Image IQ: Contralateral Breast after Cancer Diagnosis

Stamatia Destounis, MD, FACR