{"id":243,"date":"2025-06-03T22:05:12","date_gmt":"2025-06-03T22:05:12","guid":{"rendered":"https:\/\/depts.washington.edu\/breast-imaging-teach\/?p=243"},"modified":"2025-06-30T10:23:01","modified_gmt":"2025-06-30T18:23:01","slug":"case-15","status":"publish","type":"post","link":"https:\/\/depts.washington.edu\/breast-imaging-teach\/?p=243","title":{"rendered":"Case 13"},"content":{"rendered":"<p>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\">\n<h2 id=\"at-2430\" class=\"c-accordion__title js-accordion-controller\" role=\"button\">Question 1<\/h2>\n<div id=\"ac-2430\" class=\"c-accordion__content\">\n<p>A 60-year-old woman presents for a screening mammogram:<\/p>\n<figure class=\"wp-block-image\"><img loading=\"lazy\" decoding=\"async\" width=\"256\" height=\"300\" src=\"https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/MLO-3-256x300.jpg\" alt=\"\" class=\"wp-image-248\" srcset=\"https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/MLO-3-256x300.jpg 256w, https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/MLO-3-375x439.jpg 375w, https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/MLO-3.jpg 442w\" sizes=\"auto, (max-width: 256px) 100vw, 256px\" \/><\/figure>\n<figure class=\"wp-block-image\"><img loading=\"lazy\" decoding=\"async\" width=\"250\" height=\"300\" src=\"https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/CC-3-250x300.jpg\" alt=\"\" class=\"wp-image-249\" srcset=\"https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/CC-3-250x300.jpg 250w, https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/CC-3-375x449.jpg 375w, https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/CC-3.jpg 424w\" sizes=\"auto, (max-width: 250px) 100vw, 250px\" \/><\/figure>\n<p>What is responsible for the appearance of this mammogram?<br \/>A. Extremely dense breast tissue with multiple oil cysts<br \/>B. History of silicone implant rupture<br \/>C. History of direct silicone injections<br \/>D. Steatocystoma multiplex<\/p>\n<div class=\"wp-block-pb-accordion-item c-accordion__item js-accordion-item no-js\">\n<h3 id=\"at-2431\" class=\"c-accordion__title js-accordion-controller\" role=\"button\">Answer<\/h3>\n<div id=\"ac-2431\" class=\"c-accordion__content\">\n<p><strong>C. History of direct silicone injections<\/strong><\/p>\n<p><strong>Explanation:&nbsp;<\/strong>Direct injection of silicone is a method of breast augmentation that is illegal in the United States, but may still be practiced in other countries. The practice results in a mammogram with multiple high density masses (with rim calcifications) and areas of greatly increased density. Extremely dense lymph nodes may also be present. These high-density silicone breast masses make it difficult to detect a breast cancer on both physical exam and mammography.<\/p>\n<p>Steatocystoma multiplex is a skin disorder, manifesting in the breast as multiple bilateral subcutaneous oil cysts. Although this patient has multiple rim calcifications (which can also occur with oil cysts), steatocystoma multiplex would not explain the presence of so many areas of greatly increased density.<\/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-243","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\/243","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=243"}],"version-history":[{"count":4,"href":"https:\/\/depts.washington.edu\/breast-imaging-teach\/index.php?rest_route=\/wp\/v2\/posts\/243\/revisions"}],"predecessor-version":[{"id":727,"href":"https:\/\/depts.washington.edu\/breast-imaging-teach\/index.php?rest_route=\/wp\/v2\/posts\/243\/revisions\/727"}],"wp:attachment":[{"href":"https:\/\/depts.washington.edu\/breast-imaging-teach\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=243"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/depts.washington.edu\/breast-imaging-teach\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=243"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/depts.washington.edu\/breast-imaging-teach\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=243"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}