Presentation
Right breast mass.
Patient Data
Ultrasound image in the area of the palpable mass. The areola is superior almost in the center of the image. This is subareolar breast tissue. The image was interpreted as normal and no further work up was done.
The mass lesion enlarges and the patient returns 8 months later.
This is the ultrasound image (unfortunately badly cropped to exclude data) of the same area. There is now a distinct lobulated mass lesion. At this stage mammography was added (image below).
On the first image there are calcifications visible in the ducts extending in a radial fashion from the posterior aspect of the areola. This is a very good image of the ultrasound of DCIS.
Case Discussion
The final diagnosis was multifocal breast carcinoma with axillary metastases.