Discover and read the best of Twitter Threads about #breastpath

Most recents (11)

The craziness of the past week has settled down and #Breastradpath with @LizaMQuintana is back with Case 4!

53 yo had a screening MG. Maybe some new calcs or distortion in rt breast (arrow, 3D not shown)? #radres #radfellows -which images would you want during diag work-up?? Image
She returned for diag work-up. Common diag w/u is mag views for calcs and tomo spots/90 for poss AD. But we decided to start with #contrastmammo & use enhancement to triage. What do you think? Based on these images alone, does it change your level of concern???? Ddx??
Rather than showing you other diag images, which weren't that helpful, I'm showing the US. Could this be a correlate??? Does it change your level of concern?? Ddx??
Share thoughts below.... more to come tomorrow! Image
Read 13 tweets
1/ Let the tweetorials begin for our #breastradpath series with @LizaMQuintana! We're starting with the basics of screening mammography for #BCAM

Each screening mammo has 4 images-2 of the right breast and 2 of the left. If any abnormality is seen then we get more images
2/ There are 2 main areas on all mammograms - white areas are glandular tissue (part of breast that makes milk, yellow on image) & black areas are breast fat (blue). All women have both but in different proportions #breastdensity
3/ Check out what this looks like on the pathology slide. And just to give some definitions: adipose tissue=breast fat, terminal duct lobular unit=glandular tissue, stroma=supporting structure of breast #Breastpath
Read 18 tweets
Case 3 #breastradpath with @DrJordanaP

44 yo woman. On req: "faint grouped microcalcs." #breastimagers separate calcs and no calcs cores into separate containers (so helpful!). There was only one block of cores with calcs. Here are the #breastpath images. Thoughts? Next steps? ImageImage
You are all thinking the way I did! For cases with calcs, I always review the imaging, and in particular the specimen radiograph, to see the morphology of the calcs I should look for. Check out the imaging from @DrJordanaP 👇

The tiny calc in the initial levels of the CNB are not the same as the calcs seen on imaging. We need to find those calcs --> LEVELS! (I haven't heard it called steps before! I like!) #breastradpath correlation is so important here! ImageImage
Read 11 tweets
Case2 of #breastradpath with @LizaMQuintana

40 yo with focal asymmetry in rt breast on screening mg (blue arrows). See descriptions below all images.

#radres #radfellows #breastimaging #breastpath #pathology #breastmulti @BIDMC_BreastImg @BIDMCpath @DrTedJames Screening mammogram from to...
Patient returned for diagnostic #contrastmammo which confirmed focal asymmetry (blue arrows) & showed non-mass enhancement (NME) on recombined images (yellow arrows). US showed correlate. USG core done and post-MG confirmed target (yellow arrows). Contrast enhanced mammogram...Targeted ultrasound of the ...US guided core biopsy was d...
Calling all breast docs, what is your differential diagnosis? BI-RADS? Next steps??
Read 9 tweets
#breastradpath with @DrJordanaP

We are excited to share the first case in our #breastimaging and #breastpath correlation series! This case highlights challenges of imaging/management and the pathologic diagnosis.

@BIDMC_BreastImg @BIDMCpath #radres #radfellows Image
56 yo woman with left breast focal asymmetry and calcifications. Screening mammogram. @DrJordanaP Image
Diagnostic mammogram and ultrasound were performed. A presumed ultrasound correlate was found with calcs and vascularity. What is the next step? What BI-RADS would give? @DrJordanaP ImageImage
Read 17 tweets

1. Some basics of breast anatomy/histology, with broccoli, for those starting out.

Thanks to Mrs. @Teclis82 for donating part of dinner (reluctantly) for science.

@ariella8 @ADamronMD @TheKarenPinto @LizaMQuintana @RoncinMD @dr_MPrieto @TxicMegacolon
2. A cruciferous conception of the breast ductal/lobular system:

Each large branch (colored lines), along with its ramifications, defines a breast lobe. Conceptually important, but not easily identifiable anatomically.
3. Cut surface:

Pics taken from a fantastic recent review on DCIS, read it, you’ll be a better breast pathologist.

Full text:…
Read 5 tweets
1. #Breastpath Hey all, myofibroblastomas are really sweet. Let’s learn about them. @ADamronMD @TheKarenPinto @KRoSlideReview @Chucktowndoc @jennpincus @LizaMQuintana @drkennethtang @dr_MPrieto
2. Clinical: Uncommon tumors. Well circumscribed, may slowly enlarge over time. Size usu. up to 4cm. Historically (and on boards/RISE exams presently)more common in men, but now seem to occur equally in men and women.
3. A couple annotated low power pics.
Read 13 tweets
70/F with no primary, 6 cm 😟 breast mass👿👿👿.
✳️CD117, SMA, E-Cadherin, S100: ➕
📢CK7, CK20, p63, GATA3, GCDPF, Mammaglobin, ER, PR, HER2, MYB, Synaptophysin, Chromogranin, : ➖
✴️CK5/6, EMA, Actin: 30% cells
☀️Calponin, GFAP: Focal
Diagnosis❓🤔 #breastpath #Pathology ImageImageImageImage
Few other areas of the tumor. Does it change your mind? ImageImageImageImage
Read 3 tweets
Breast biopsy for calcs. What is your diagnosis? Would you do stains? Since I’m asking that means I did 😉🔬 #breastpath @BIDMCpath @CollinsLauraC @jennpincus @RanaAldreesMD @tlabiano @lara_pijuan @ADamronMD @ariella8 @kis_lorand @TheISBP ImageImageImageImage
Thanks for all the comments! Here are the stain. All (including p120, not pictured) were consistent with a lobular phenotype. ImageImage
There were some hints in the background with areas of classical LCIS. ImageImage
Read 6 tweets
Breast excision. What is your diagnosis? Would you do stains? #breastpath ImageImageImage
Thanks everyone! This is LCIS involving collagenous spherulosis. I did IHC. The e-cad was stronger than I expected but showed granular staining so I followed up with p120 and beta-catenin to illustrate the different stains.
Read 5 tweets

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