Tatiane Cantarelli summarized best:
I think the clavicular and scapular changes are post-radiation cortical and trabecular thickening with fatty replacement, nothing worrisome.
The calcifications look like dystrophic post-treatment sequelae.
However, the manubrial lesion is definitely concerning. it has a more aggressive appearance with marrow infiltration, and I really think this represents metastasis
On Wed, Oct 22, 2025 at 12:44 PM hilary wrote:
OCAD is popping with activity…I’m So excited…but I really need your help…
History, which I mostly gleaned from previous CT reports, is that she had breast cancer "many years" ago and had right sided mastectomy. She has bronchiectasis and / or pulmonary fibrosis with some history of radiation therapy.
Through the years with the earliest available CT from 2021 they report Right sided bone changes attributed to RTx and dense calcifications in the region of the Rt sternoclavicular joint and anterior chest wall.
These have been reported as unchanged…but I think the manubrial lesion has enlarged.
The manubrial marrow is infiltrated, the bone is mildly expanded and there is enhancement…but the calcification erode into the right side of the manubrium,
The calcifications erode into the clavicle…with thin peripheral enhancement.
I wonder if the Right scapula is old post RTx change….kind of looks like Paget, but there in normal marrow signal and no enhancement.
Currently there is a moderate sized Rt sided pleural effusion (not shown).
How should I report the manubrial lesion?
Is it indeterminate?
Post Radiation….Metastases….other?
