Presentation
Routine biennial mammograms for screening.
Patient Data
Nodular density with irregular margins and a cluster of microcalcifications located in the right breast outer inferior quadrant.
Mammo workup compression/magnification/extended views
Extended views with compression and magnification confirms the 1.0 cm nodular density with irregular margins and a cluster of pleomorphic microcalcifications.
Ultrasound confirmed the mammographic lesion as a solid hypoechogenic nodule, as taller as wider, with irregular margins, and no clear internal vascularity.
US-guided core biopsy using a 14G needle and 3 passes. No suspicious lymph nodes in the right axillary cavum.
Case Discussion
This case illustrates a highly suspicious lesion depicted on the routine mammogram which, regardless the result of the biopsy, should be excised. US-guided core biopsy confirmed an invasive carcinoma.
MACROSCOPIC DESCRIPTION: "Right breast 3 o'clock 3cm from the nipple, Cat A": Tan white and brown needle cores 13mm in aggregate. A1.
MICROSCOPIC DESCRIPTION: Sections show predominantly fibrous stroma with small fatty areas. There are malignant cells both singly and a nested and linear architecture set within a desmoplastic stroma. The cells have pleomorphic hyperchromatic nuclei and mitoses are abundant. There is moderate background inflammation. An in-situ component contains comedo necrosis.
DIAGNOSIS: Right breast biopsy, 3 o'clock: Invasive carcinoma, grade 3.