{"id":170,"date":"2025-06-03T20:44:08","date_gmt":"2025-06-03T20:44:08","guid":{"rendered":"https:\/\/depts.washington.edu\/breast-imaging-teach\/?p=170"},"modified":"2025-06-30T10:21:28","modified_gmt":"2025-06-30T18:21:28","slug":"case-8","status":"publish","type":"post","link":"https:\/\/depts.washington.edu\/breast-imaging-teach\/?p=170","title":{"rendered":"Case 7"},"content":{"rendered":"<p class=\"wp-block-paragraph\">Contributed by: Steven J. Rockoff, MD and Diana L. Lam, MD &#8211; June 1, 2020<\/p>\n<div class=\"wp-block-pb-accordion-item c-accordion__item js-accordion-item no-js\" data-initially-open=\"false\" data-click-to-close=\"true\" data-auto-close=\"true\" data-scroll=\"false\" data-scroll-offset=\"0\">\n<h2 id=\"at-1700\" class=\"c-accordion__title js-accordion-controller\" role=\"button\">Question 1<\/h2>\n<div id=\"ac-1700\" class=\"c-accordion__content\">\n<p class=\"wp-block-paragraph\">A 50-year-old woman presents for a screening mammogram:<\/p>\n<figure class=\"wp-block-image is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"248\" src=\"https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/70-MLO-300x248.jpg\" alt=\"\" class=\"wp-image-173\" style=\"width:561px;height:auto\" srcset=\"https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/70-MLO-300x248.jpg 300w, https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/70-MLO-375x310.jpg 375w, https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/70-MLO.jpg 680w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/figure>\n<figure class=\"wp-block-image is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"261\" src=\"https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/70-CC-300x261.jpg\" alt=\"\" class=\"wp-image-174\" style=\"width:563px;height:auto\" srcset=\"https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/70-CC-300x261.jpg 300w, https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/70-CC-375x326.jpg 375w, https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/70-CC.jpg 603w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/figure>\n<p class=\"wp-block-paragraph\">What kind of implants are present?<\/p>\n<p class=\"wp-block-paragraph\">A. Saline implants<br \/>B. Silicone implants<br \/>C. Ceramic implants<\/p>\n<div class=\"wp-block-pb-accordion-item c-accordion__item js-accordion-item no-js\" data-initially-open=\"false\" data-click-to-close=\"true\" data-auto-close=\"true\" data-scroll=\"false\" data-scroll-offset=\"0\">\n<h3 id=\"at-1701\" class=\"c-accordion__title js-accordion-controller\" role=\"button\">Answer<\/h3>\n<div id=\"ac-1701\" class=\"c-accordion__content\">\n<p class=\"wp-block-paragraph\"><strong>B. Silicone implants<\/strong><\/p>\n<p class=\"wp-block-paragraph\"><strong>Explanation:&nbsp;<\/strong>The extremely high and homogenous density of these implants indicates that they are composed of silicone.<\/p>\n<p class=\"wp-block-paragraph\">With saline implants, we should be able to see \u201cthrough\u201d and identify the implant valves.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"wp-block-pb-accordion-item c-accordion__item js-accordion-item no-js\" data-initially-open=\"false\" data-click-to-close=\"true\" data-auto-close=\"true\" data-scroll=\"false\" data-scroll-offset=\"0\">\n<h2 id=\"at-1702\" class=\"c-accordion__title js-accordion-controller\" role=\"button\">Question 2<\/h2>\n<div id=\"ac-1702\" class=\"c-accordion__content\">\n<p class=\"wp-block-paragraph\">There is a unilateral finding present. What is it?<\/p>\n<p class=\"wp-block-paragraph\">A. Right breast retroareolar mass<br \/>B. Right breast extracapsular implant rupture<br \/>C. Left breast lower outer quadrant fat-containing mass<br \/>D. Left axillary mass<\/p>\n<div class=\"wp-block-pb-accordion-item c-accordion__item js-accordion-item no-js\" data-initially-open=\"false\" data-click-to-close=\"true\" data-auto-close=\"true\" data-scroll=\"false\" data-scroll-offset=\"0\">\n<h3 id=\"at-1703\" class=\"c-accordion__title js-accordion-controller\" role=\"button\">Answer<\/h3>\n<div id=\"ac-1703\" class=\"c-accordion__content\">\n<p class=\"wp-block-paragraph\"><strong>C. Left breast lower outer quadrant fat-containing mass<\/strong><\/p>\n<p class=\"wp-block-paragraph\"><strong>Explanation:&nbsp;<\/strong>The fat-containing mass shown below is present in the lower outer quadrant of the left breast.<\/p>\n<p class=\"wp-block-paragraph\">Mammography is not a sensitive modality to assess for silicone implant rupture, although there is no gross evidence of extracapsular silicone implant rupture on these images. Saline implant rupture is a clinical diagnosis.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"wp-block-pb-accordion-item c-accordion__item js-accordion-item no-js\" data-initially-open=\"false\" data-click-to-close=\"true\" data-auto-close=\"true\" data-scroll=\"false\" data-scroll-offset=\"0\">\n<h2 id=\"at-1704\" class=\"c-accordion__title js-accordion-controller\" role=\"button\">Question 3<\/h2>\n<div id=\"ac-1704\" class=\"c-accordion__content\">\n<figure class=\"wp-block-image is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"292\" src=\"https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/70-zoom-2-300x292.jpg\" alt=\"\" class=\"wp-image-177\" style=\"width:455px;height:auto\" srcset=\"https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/70-zoom-2-300x292.jpg 300w, https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/70-zoom-2.jpg 308w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/figure>\n<figure class=\"wp-block-image is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"283\" height=\"257\" src=\"https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/70-zoom-1.jpg\" alt=\"\" class=\"wp-image-178\" style=\"width:449px;height:auto\"\/><\/figure>\n<p class=\"wp-block-paragraph\">What is the best descriptor for the type of calcification that is seen with this fat-containing mass?<\/p>\n<p class=\"wp-block-paragraph\">A. Rim calcification<br \/>B. Round calcification<br \/>C. Fine linear branching calcification<br \/>D. Popcorn-like calcification<\/p>\n<div class=\"wp-block-pb-accordion-item c-accordion__item js-accordion-item no-js\" data-initially-open=\"false\" data-click-to-close=\"true\" data-auto-close=\"true\" data-scroll=\"false\" data-scroll-offset=\"0\">\n<h3 id=\"at-1705\" class=\"c-accordion__title js-accordion-controller\" role=\"button\">Answer<\/h3>\n<div id=\"ac-1705\" class=\"c-accordion__content\">\n<p class=\"wp-block-paragraph\"><strong>A. Rim calcification<\/strong><\/p>\n<p class=\"wp-block-paragraph\"><strong>Explanation:&nbsp;<\/strong>A rim calcification is composed of a continuous rim of thin (\u2264 1 mm) calcification that surrounds a round or oval structure, usually with distinct internal fat density, as is true for this case. This large rim calcification has the typical appearance of fat necrosis, as can be seen in the setting of prior breast trauma or surgery (such as implant placement). Oil cysts or simple cysts (not shown in this case) can also have smaller rim calcifications. Rim calcifications are typically benign.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Contributed by: Steven J. Rockoff, MD and Diana L. Lam, MD &#8211; June 1, 2020<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6],"tags":[],"class_list":["post-170","post","type-post","status-publish","format-standard","hentry","category-quiz"],"_links":{"self":[{"href":"https:\/\/depts.washington.edu\/breast-imaging-teach\/index.php?rest_route=\/wp\/v2\/posts\/170","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/depts.washington.edu\/breast-imaging-teach\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/depts.washington.edu\/breast-imaging-teach\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/depts.washington.edu\/breast-imaging-teach\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/depts.washington.edu\/breast-imaging-teach\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=170"}],"version-history":[{"count":4,"href":"https:\/\/depts.washington.edu\/breast-imaging-teach\/index.php?rest_route=\/wp\/v2\/posts\/170\/revisions"}],"predecessor-version":[{"id":673,"href":"https:\/\/depts.washington.edu\/breast-imaging-teach\/index.php?rest_route=\/wp\/v2\/posts\/170\/revisions\/673"}],"wp:attachment":[{"href":"https:\/\/depts.washington.edu\/breast-imaging-teach\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=170"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/depts.washington.edu\/breast-imaging-teach\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=170"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/depts.washington.edu\/breast-imaging-teach\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=170"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}