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Infiltrating Ductal

Carcinoma
NICOLE WOLCOTT
DMS 496
SUMMER TRIMESTER 2015

Case History
Age: 35 year old
Sex: Female
Labs:
WBC: Increased with abscess or mastitis
Hematocrit: Extremely increased with hematoma
Estrogen: Some cancers fueled by high levels of estrogen
CA-125: Increased in some forms of breast cancer

Case History
Exam Ordered: Breast Ultrasound
Reason for Exam: Baseline study due to family history
Current Symptoms: Asymptomatic
Previous Imaging:
Mammogram: No suspicious masses or any malignant
appearing calcifications
Breast Ultrasound: Asymmetric lymph node in the right axilla
MRI: Highly suspicious area of enhancement in the lateral
aspect of the right breast 9:00

Sonographic Findings

Figure 1: Abnormal lymph node in


right axilla

Figure 2: MRI showing area of


interest

Sonographic Findings

Figure 3: Gray scale image of mass

Figure 4: Color Doppler image showing


lack of blood flow within the mass

Sonographic Findings

Figure 5: Mass measurement in radial

Figure 6: Mass measurement in


antiradial

Diagnosis
Infiltrating Ductal Carcinoma
Mutation of epithelial cells which form a malignant mass that
spreads from inside the breast ducts and invades surrounding
tissue

Common symptoms:
Solitary, hard, painless, skin dimpling or retraction

Common sonographic findings:


Solid mass, ill defined, spiculated, irregular angular margins,
echogenic halo, taller than wide

Diagnosis
Key Facts:
Most common breast malignancy (75%)
Most common type of breast cancer in men

Prevalence:
About 1 in 8 (12%) women in the US will develop
invasive breast cancer during their lifetime
Accounts for about 8 out of 10 of all invasive breast
cancers

Follow Up
Biopsy performed
Pathology report positive for malignancy consistent with
infiltrating ductal carcinoma

Treatment plan:
No treatment recorded
Lumpectomy, mastectomy, chemotherapy, radiation
therapy

Prognosis:
Depends on multiple social, biologic, and independent
patient factors

Conclusion
Teachable Moment:
Utilize color Doppler
Utilize spectral Doppler
Always check patient history
Scan slowly

Take Away:
Do anything and everything necessary to find a
suspected pathology

References
1. Stephan, Pam. "Invasive Ductal Carcinoma - IDC." About Health. 16
December 2014. Web. 08 July 2015.
<http://breastcancer.about.com/od/types/p/idc.htm>.
2. Charboneau J, Levine D, Rumack C, Wilson S: Diagnostic Ultrasound.
4th ed. Vol 1. Philadelphia, PA, Elsevier Mosby, 2011, pp 798
3. "What are the Key Statistics About Breast Cancer?" Cancer.org.
American Cancer Society, 10 June 2015. Web. 08 July 2015.
<http://www.cancer.org/cancer/%20breastcancer/detailedguide/breastcancer-key-statistics>.
4. Tohno E, Ueno E. Ultrasound (US) diagnosis of nonpalpable breast
cancer. Breast Cancer 2005; 12:267271

References
5. Paulinelli RR, Freitas-Jnior R, Moreira MAR, et al. Risk of
malignancy in solid breast nodules according to their sonographic
features. J Ultrasound Med 2005; 24:635641
6. Kang DK, Jeon GS, Yim H, Jung YS. Diagnosis of the intraductal
component of invasive breast cancer assessment with
mammography and sonography. J Ultrasound Med 2007; 26:1587
1600.
7. Osako T, Takahashi K, Iwase T, et al. Diagnostic ultrasonography
and mammography for invasive and noninvasive breast cancer in
women aged 30 to 39 years. Breast Cancer 2007; 14:229233