Question
During a follow-up appointment, a 45-year-old female presents for evaluation. What finding is observed on her chest x-ray?
| A. |
Tuberculosis
|
| B. |
COPD
|
| C. |
Post-mastectomy of the left side
|
| D. |
Post-mastectomy of the right side
|
Show Answer
|
Correct Answer » C
Explanation
|
|
- The chest X-ray shows asymmetry of the breast shadows.
- There is absence of the soft tissue breast shadow on the left side (note: radiographic left corresponds to patient’s left; marker “L” confirms orientation).
- The right side shows a normal breast shadow, while the left side appears relatively lucent (darker).
- This is a classic radiographic feature of post-mastectomy status.
Clinical Reasoning
- Breast tissue normally creates a soft tissue density on chest X-ray.
- After mastectomy, this density is lost → resulting in increased lucency on that side.
- This is commonly seen in patients with prior breast cancer surgery.
- Left-sided mastectomy explains the loss of soft tissue shadow on the left hemithorax, producing asymmetry.
Why Other Options are Incorrect
A. Pulmonary Tuberculosis
- Would show:
- Upper lobe cavitations
- Fibrosis, nodules, or consolidation
- These features are not present in this X-ray.
B. Chronic Obstructive Pulmonary Disease (COPD)
- Typical findings:
- Hyperinflated lungs
- Flattened diaphragm
- Increased retrosternal air space
- These are not evident here.
D. Status post right-sided mastectomy
- The right breast shadow is present
