Secondary Metachronic Invasive Ductal Carcinoma 23 Years After

Hi , it is me again.

Breast Cancer Survivor Women have  an increased risk for developing a secondary or metachronic breast cancer either in the same gland or in the opposite one.

It has been calculated around 5-10% and it would be progressively higher as time and age goes by.

This week I attended a 65 year old woman , that when she was 42 she had LEFT Stage III Breast Cancer ....... as she managed to survived after complete treatment she has been then under follow up.

LAST YEAR AUGUST 2012 She said to feel an small asymptomatic irragularity less than 1 cm in her inner quadrant of her remaining RIGHT breast and went for her annual Mammography with these images reported :

 Cefalo Caudal View and Close Up , a single Macrocalcification is seen in the INNER QUADRANTS

Slight density near it.

Medio Lateral Oblique View , moderate density , the same macrocalcification and  scattered densities
Probably Benign Inflammatory Lymph Nodes

Close up : Macrocalcification associated density.

BACK THEN BIRADS II 

Radiologist had no clear information to recommend a COMPLEMENTARY procedure.

NOW IF YOU WERE HER BREAST SURGEON OR ONCOLOGIST WOULD YOU CONCUR?

Ultrasound was added and final report sent : 

Final Radiological Intepretacion was Compatible with Benign Fybroid , yet considering biopsy?

As a complementary procedure  I performed : 

Digital Infrared Images were taken with the standard protocol and interpretation , developed for the last 4 years:

Basal frontal view  , area of interest , upper inner quadrant is one or IR activity easily detected and coincident for clinical findings. Directly "sepaking" of inherent metabolic activity.

After cold stress or stimuli , the same area is defined clearly as the highest peak or IR summit of the right breast.

Demonstrating : that these area "refuses" to get colder and that is the area of highest infrared radiation emmisivity....

Patient was scheduled for total excision of the nodule , with a pathologic report in the OR : 

Invasive Carcinoma was diagnosed and as consented previously , Mastectomy was undertaken with Sentinel Lymph Node......

Final immunohystochemical results were realised with the following reports:

Solid Papillary Invasive Carcinoma , Grade 2 
Progesterone and Estrogen Receptors  +++
Ki 67 positive in about 20% of the neoplastic cells and 
Her 2 Neu Negativity.

Comments :Digital  IR Image can aid standard radiological , morphological procedures such as Mammography and Ultrasound.

Is safe and practical .

Gives useful information for the Breast Specialist (Oncologist or Breast  Radiologist)

And actually can be related not only to its invasivity but for METABOLICAL individual Characteristics , such as final IHQ results : Hormone Receptirs , Ki 67 and Her 2 neu.

Have a good one ......