Open Access

Ultrasound-guided vacuum-assisted breast biopsy in the diagnosis of cancer recurrence at the surgical scar: a report of three cases

Laila Abu Tahoun
Laila Abu Tahoun
 and 
Bayan Maraqa
Bayan Maraqa
   | Feb 08, 2022
Journal of Ultrasonography's Cover Image
About this article
Previous Article
Next Article
Cite
Article Category: Case report
Published Online: Feb 08, 2022
Page range: 57 - 63
Received: Aug 21, 2021
Accepted: Nov 17, 2021
DOI: https://doi.org/10.15557/JoU.2022.0010
Keywords
© 2022 Laila Abu Tahoun, Bayan Maraqa, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Fig. 1

A. Mammogram LMCC shows surgical clips at the surgical scar in the upper outer left breast. Group of suspicious calcifications anterior to surgical clips (arrow). Multiple other groups of suspicious linear calcifications in the lower inner left breast (curved arrow). B. Breast MRI axial subtraction post-contrast image shows a suspicious enhancing mass measuring 1.4 x 0.9 cm at the scar posteriorly. Another adjacent tiny enhancing mass seen inferiorly in the posterior third of the mid-outer left breast (image C). C. Focal non-mass enhancement at 3:00 in the anterior third of the left breast (solid arrow). D. Sagittal MR MIP rotated image shows enhancing masses at the region of the scar posteriorly (arrow) and non-mass enhancement (solid arrow). E. Ultrasound showed post-operative scar in the upper outer left breast. Subtle hypoechoic lesion anterior to the scar may correlate with suspicious calcifications on mammogram (arrow). F. Heterogeneous non-specific lesion may represent ductal abnormality in the mid-outer periareolar left breast correlating with non-mass enhancement on MRI (solid arrow)
A. Mammogram LMCC shows surgical clips at the surgical scar in the upper outer left breast. Group of suspicious calcifications anterior to surgical clips (arrow). Multiple other groups of suspicious linear calcifications in the lower inner left breast (curved arrow). B. Breast MRI axial subtraction post-contrast image shows a suspicious enhancing mass measuring 1.4 x 0.9 cm at the scar posteriorly. Another adjacent tiny enhancing mass seen inferiorly in the posterior third of the mid-outer left breast (image C). C. Focal non-mass enhancement at 3:00 in the anterior third of the left breast (solid arrow). D. Sagittal MR MIP rotated image shows enhancing masses at the region of the scar posteriorly (arrow) and non-mass enhancement (solid arrow). E. Ultrasound showed post-operative scar in the upper outer left breast. Subtle hypoechoic lesion anterior to the scar may correlate with suspicious calcifications on mammogram (arrow). F. Heterogeneous non-specific lesion may represent ductal abnormality in the mid-outer periareolar left breast correlating with non-mass enhancement on MRI (solid arrow)

Fig. 2

A. Mammogram LMCC showed post-operative scarring in the upper outer left breast. Developing asymmetry with suspicious linear calcifications at and just anterior to the scar, measuring 1.2 × 0.4 cm. B. Ultrasound showed post-operative changes in the upper outer left breast with a subtle small hypoechoic lesion close to the surgical scar in the upper outer left breast (2:00–3:00) measuring less than 1 × 1 cm (arrow). C. Another subtle irregular hypoechoic mass with adjacent shadowing and a few tiny hypoechoic lesions (abnormal duct-like appearance) at periareolar 1:00, may correlate with mammographically seen calcifications and measures 1 × 0.5 cm. D. MR showed non-mass enhancement at 1:00 in the left breast (solid arrow) and non-mass enhancement at the scar in the posterior third of the upper outer left breast (curved arrow). E. Reconstructed sagittal MR image shows non-mass enhancement in the upper outer left breast (solid arrow) and few enhancing foci close to the scar in the deep upper outer breast (curved arrow)
A. Mammogram LMCC showed post-operative scarring in the upper outer left breast. Developing asymmetry with suspicious linear calcifications at and just anterior to the scar, measuring 1.2 × 0.4 cm. B. Ultrasound showed post-operative changes in the upper outer left breast with a subtle small hypoechoic lesion close to the surgical scar in the upper outer left breast (2:00–3:00) measuring less than 1 × 1 cm (arrow). C. Another subtle irregular hypoechoic mass with adjacent shadowing and a few tiny hypoechoic lesions (abnormal duct-like appearance) at periareolar 1:00, may correlate with mammographically seen calcifications and measures 1 × 0.5 cm. D. MR showed non-mass enhancement at 1:00 in the left breast (solid arrow) and non-mass enhancement at the scar in the posterior third of the upper outer left breast (curved arrow). E. Reconstructed sagittal MR image shows non-mass enhancement in the upper outer left breast (solid arrow) and few enhancing foci close to the scar in the deep upper outer breast (curved arrow)

Fig. 3

A. MLO mammogram. B. Magnification views shows post-operative scarring in the upper outer left breast with surgical clips. New developing focal asymmetry at (arrow) just lateral to the scar. C. Post biopsy mammogram shows the clip (solid arrow). MR images T1W axial images (D, E), MR axial subtracted post-contrast images (F, G) and reconstructed sagittal post-contrast MR image (H) show post-operative surgical clip and adjacent architectural distortion with enhancement (I, J). Ultrasound image shows a large heterogeneous hyperechoic mass in the outer mid and upper left breast, with visible small regions of hypoechoic shadowing
A. MLO mammogram. B. Magnification views shows post-operative scarring in the upper outer left breast with surgical clips. New developing focal asymmetry at (arrow) just lateral to the scar. C. Post biopsy mammogram shows the clip (solid arrow). MR images T1W axial images (D, E), MR axial subtracted post-contrast images (F, G) and reconstructed sagittal post-contrast MR image (H) show post-operative surgical clip and adjacent architectural distortion with enhancement (I, J). Ultrasound image shows a large heterogeneous hyperechoic mass in the outer mid and upper left breast, with visible small regions of hypoechoic shadowing

Fig. 4

Pathological examination revealed multifocal nodular aggregates of high grade tumor cells with pleomorphic nuclei and prominent nucleoli. Typical single file pattern and targetoid growth are seen infiltrating around ducts and between fat lobules. Pathological examination confirmed invasive pleomorphic lobular carcinoma
Pathological examination revealed multifocal nodular aggregates of high grade tumor cells with pleomorphic nuclei and prominent nucleoli. Typical single file pattern and targetoid growth are seen infiltrating around ducts and between fat lobules. Pathological examination confirmed invasive pleomorphic lobular carcinoma
eISSN:
2451-070X
Language:
English
Publication timeframe:
4 times per year
Journal Subjects:
Medicine, Basic Medical Science, other
Journal RSS Feed