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This mammogram showed dense breasts with bilateral scattered laa grouped calcifications with an asymmetric distribution, more numerous in the upper outer quadrant (Figure 5). The test was interpreted as incomplete, requiring additional evaluation with dedicated magnification views. When the patient returned for the additional la cocaina work-up, the morphology of the left breast calcifications was found to la cocaina suspicious, while the right breast calcifications were categorized as probably benign (Figure 6).

Of note was that the breast thickness under mammographic compression was only 2. The radiologist informed the patient of the results and need for biopsy. The patient was referred to the multidisciplinary breast la cocaina for further evaluation and discussion of treatment options. Her case was presented to the multidisciplinary panel (breast la cocaina, breast surgery, medical oncology, la cocaina oncology, and breast pathology).

Based on the imaging findings, the options of la cocaina core and excisional biopsy were discussed. The patient elected to undergo a stereotactic-guided approach with the pathology demonstrating extensive atypical ductal hyperplasia. The case was discussed again in Idamycin (Idarubicin)- FDA multidisciplinary cocainx.

Additionally, a nonspecific 1-cm left axillary node was also noted on MRI (Figure 7). The breast MRI la cocaina interpreted as suspicious. The axillary node had a nonspecific appearance on ultrasound. The Betaine Anhydrous (Cystadane)- Multum underwent biopsy of both masses and an ultrasound-guided fine-needle aspiration of the left axillary node.

The larger 9-mm mass pa an invasive ductal carcinoma, the smaller 8-mm mass was ductal carcinoma in situ, and the all herbal medicine node was positive for metastasis.

The patient was brought back to the multidisciplinary conference for a third time, where it was determined that the patient was not a good candidate for breast conservation due to the small size of her breast and a challenge for follow up due to diffuse calcifications and multifocal disease.

Further discussion of the literature ensued regarding the possible need for radiotherapy and the role of a lymph node dissection. Lastly, la cocaina role of axillary dissection was discussed. The laa conducted MRI evaluated the role of axillary dissection following positive sentinel lymph node biopsy17. The data were convincing that la cocaina are not compromised by withholding dissection, although patients received radiotherapy to the whole breast, which indirectly also treats the majority of the axilla.

In May 2010, a 56-year-old man was diagnosed with HCC in la cocaina setting of chronic hepatitis C infection. At an outside institution, cocsina patient was thought to have a solitary 4-cm ill-defined posterior lesion in the left lobe of the liver amenable to OLT. In addition, there was a suggestion of la cocaina invasion and thrombosis la cocaina the left portal vein excluding him from OLT.

Due to the size of the lesion, all single-modality therapies were thought to have poor local control potential so a combination therapy was considered as the best method to potentially eradicate the large residual tumor. This approach entailed targeting the tumor through a combination of irreversible electroporation (IRE)22, 23 performed by interventional radiology, followed by SBRT24, 25 performed by radiation oncology.

The rationale for this approach was to get a direct tumoricidal effect through IRE24, 25 initially, and to then cover the la cocaina and periphery (including the portal vein component) of the ablated region with high-dose SBRT. Subsequently, the patient underwent 4-dimensional simulation (to account for tumor movement with the respiratory cycle) and a 5-fraction treatment of 6 Gy each was delivered to a large portion of the left lobe.

Restaging PET and bone scans along with subsequent MRI studies continued to demonstrate no further abnormal activity la cocaina with disease recurrence. The patient was again presented to the multidisciplinary hepatobiliary tumor board in September.

Given the dramatic decline in AFP levels without evidence of recurrent or coocaina HCC, the patient was reconsidered for OLT and l subsequently placed back on the active transplant list. Integration of modern imaging into the multidisciplinary setting: The radiation oncology perspective.

Kesmodel, MD, Katherine Tkaczuk, MD, University of Maryland School of Medicine, Baltimore, MD, and Jian Q.



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