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What would you do if you are following up on a lesion labelled at a different o’clock position to the location you find the lesion? & it is obviously the same lesion for e.g. you find one at 7 oclock but it has previously been labeled at 5 o’clock . (In this example, the lady has put on a lot of weight since prev scan .)
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This is not a problem isolated to breast ultrasound. There is occasionally a disconnect between a previous scan / report and the findings I make on the current scan.
It may be that a liver lesion is reported as being in a particular segment and I disagree or a carotid ultrasound grades a stenosis at a higher level than I find on my scan etc.
So certainly I am going to find breast lesions in slightly different locations to the prior scan.
In all of these examples I trust MYSELF and report the findings as I find them.
In breast work it may be the position of the patient (how rolled the patient was), also weight gain or loss may make a difference.
I am very careful to ensure that the lesion looks morphologically like the same lesion and that the surrounding tissue looks similar.
If I can satisfy all of this I report the lesion at whatever o’clock I finds it in and make note on my worksheet that last time it was reported in a slightly different position.
I take the same approach to other ultrasound inconsistencies.
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