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Breast » Breast
Recurrent carcinoma of the breast at lumpectomy site
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Author(s) :
Pat Romilly
Presentation Patient for follow-up;status post lumpectomy for carcinoma of the right breast.
Caption: First mammogram-RCC view-post surgical status
Description: An area of increased density is seen at the lumpectomy site in this cranio-caudal view.
Caption: Follow up mammogram-RCC view-post surgical status
Description: The surgical scar site shows an increase in density.
Caption: Follow up mammogram-RMLO view-post surgical status
Description: The scar site in this view also shows an increase in density. This is suspicious for some pathology beneath the scar tissue.
Caption: Sonogram of the scar site
Description: Ultrasound of the scar site shows a hypoechoic mass amidst the post surgical changes.
Caption: Doppler image of the scar area
Description: The hypoechoic mass seen beneath the scar area is clearly visible. This Doppler image shows color flow inside the mass indicating its solid nature.
Differential Diagnosis recurrent tumor, seroma

Final Diagnosis Recurrent carcinoma of the breast at lumpectomy site
Case References 1. Belli P et al. Role of magnetic resonance imaging in the diagnosis of recurrence after breast conserving therapy. Rays. 2002 Oct-Dec; 27(4) 241-57
2. Ringberg et al. Ipsilateral local recurrence in relation to therapy and morphological characteristics in patients with ductal carcinoma in situ of the breast. Eur J Surg Oncl. 2000 Aug;26 (5) 444-51
3. Robyn L Birdwell and Roger J Jackman. Clip or marker migration 5-10 weeks after stereotactic 11 guage vacuum assisted breast biopsy – Report of 2 cases. Radiology 2003 229: 541-544
Follow Up A Stereotactic core biopsy was performed in 2003 and pathology reported fibrosis and fat necrosis which was felt to be concordant.
However, a year later the follow up mammogram showed an increase in scar density. A biopsy performed then revealed recurrent carcinoma.
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