Tumark® Vision Atlas
A 37 year-old patient with invasive ductal cancer
Prof. Dr. Joerg Heil, Universitäts-Frauenklinik Heidelberg, Germany
The patient presented in February 2017 for an evaluation of an unclear finding in her left breast that was discovered during a screening session. Mammographic evidence of a lesion was found in two levels in the imaging, on the left side at 1 o’clock, extending to over 11 x 10mm in size, ACR 3, BIRADS 5. Ultrasound evidence of an unclear and suspicious lesion on the left at 1 o’clock position, extending to over 10 x 10 x 11 mm in size, BIRADS 5. An ultrasound-guided punch biopsy result is a moderately differentiated HER2 phenotype breast cancer NST G2. Prior to neoadjuvant chemotherapy, ultrasound-guided lesion marking was performed with Tumark Vision (figure 1).
Course of treatment
During ultrasound and mammography follow-ups carried out at two, three and five months after marking, the clipmarker was clearly visible in the ultrasound and mammographic imaging within the tumor bed (figures 2-6) in a finding no longer clearly distinguishable.
Upon completion of NACT consisting of 6 x TCbHP, segment resection with ALND was performed. After sample radiography and radiological examination (confirmation with a mammography), a second resection, medio-cranial, was recommended and performed. In sample radiography, the Tumark Vision was clearly visible in the resected segment tissue (figure 8). The histological finding suggests a pathological complete remission (ypT0, ypNo, Lo).
In the case presented, the Tumark Vision was clearly distinguished in the ultrasound scans as a hyperechoic, ring-shaped structure throughout the complete course of neoadjuvant therapy. Due to the limited tumor differentiation, here in complete remission already after the first NACT cycle, long-term dstinguishing of the clip was helpful during follow-ups.