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Invasive Ductal

Carcinoma
Kristen Cherry & Shelley Kraft
DMS 497 Clinical Practicum IV
Fall 2014

Case History
The patient:
26 years old
African American
Female
Weight not
available
(outpatient)

Case History
No pertinent medical history
No lab values available
Patient revealed family history of
breast cancer
Paternal grandmother

Palpable mass in right breast

Sonographic Findings

Figure 1. Right breast mass in the


antiradial scan plane with measurements.

Sonographic Findings

Figure 2. Right breast mass in the radial


scan plane with measurements.

Sonographic Findings

Figure 3. Color Doppler shows a centrally


located feeding vessel in the mass.

Sonographic Findings

Figure 4. Abnormal lymph node visualized


in the right axilla.

Sonographic Findings

Figure 5. Hypervascularity identified within


the right axillary lymph node.

Sonographic Findings

Figure 6. Biopsy taken from right breast


mass.

Diagnosis
Actual diagnosis:
Invasive ductal carcinoma

Definition:
A cancer of the ductal

epithelium that has broken


through the duct wall to invade
surrounding tissues
Figure 7. Terminal duct location.

Diagnosis
Common Sonographic
Features:
Enlarged duct
Taller than wide
Hypoechoic
Posterior shadowing and
possible echogenic halo
Vascularity

Diagnosis
Key Facts:

Most common type of breast malignancy80% of cases


Dilated ducts can be followed back to the site of the mass
Risk increases with age, personal and family history
Present with palpable, painless, hard mass

Other Modalities:
Mammography

Diagnosis
Laboratory values:
BRCA
Hormone receptors
HER2/NEU

CA 15-3

Conclusion
Literature Review Findings:
Sonographic findings and clinical presentation
supported
Common incidence correlates very little with this case

Sonographer should always thoroughly


evaluating the axillary lymph nodes
Treatment:
Surgery, radiation, &/or chemotherapy

References
1. Hagen-Ansert S. Textbook of Diagnostic Ultrasonography. Philadelphia, PA: Mosby Inc.: 2001.
2. Sanders R. Clinical Sonography A Practical Guide. Philadelphia, PA: Lippincott Williams &
Wilkins: 1998.
3. Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. Philadelphia, PA:
Mosby, Inc.: 2011.
4. Fox T. Mammography for the Breast Sonographer [Webinar]. Plano, TX: Society of Diagnostic
Medical Sonography: 2011-2013.
5. Krag K, Turkington C. The Encyclopedia of Breast Cancer. New York, NY: Facts on File, Inc.:
2005.
6. Smithuis R, Pijnappel R. Breast CalcificationsDifferential Diagnosis and BIRADS. The
Radiology Assistant Website. http://rad.desk.nl/en/4793bfde0ed53. Updated November 5,
2008. Accessed March 20, 2014.
7. Agency for Healthcare Research and Quality, National Cancer Institute, Lab Tests Online, and
BreastCancer.org. Lab Tests. National Breast Cancer Foundation, Inc.
http://www.nationalbreastcancerfoundation.org/breast-cancer-lab-tests. Last updated 2012.
Accessed October 18, 2014.