Axillary tail breast cancer

Case contributed by Dr Henry Knipe

Presentation

Palpable lump.

Patient Data

Age: 60 years
Gender: Female
Mammography

Asymmetric density seen in the right axillary region. No further suspicious mass, calcification or areas of architectural distortion. 

Mammography

This view demonstrates a density that correlates to abnormality seen on the right MLO view. Now the abnormality is visible in two views, and hence should be treated as a mass. 

Mammography

Magnification coned compression views in MLO and CC confirm the presence of a spiculated mass.  

Ultrasound

Hypoechoic shadowing mass at 12 o'clock in the right upper outer breast (axillary tail), approximately 12 cm FN. Echogenic rim with vascularity and sonographic spiculation. No abnormal axillary lymph nodes were seen.

 Under ultrasound guidance 3 x 14G core biopsies through the mass were obtained. 

CORE BIOPSY HISTOPATHOLOGY RESULTS

MICROSCOPIC DESCRIPTION: Serial sections show infiltration of all three cores by invasive carcinoma. Tumour cells have moderately pleomorphic angulated hyperchromatic nuclei and a variable amount of pale cytoplasm and are arranged in variably sized solid aggregates within a fibrous and elastotic stroma. There is minimal duct/tubule formation. An occasional mitotic figure is identified. Tumour is seen to extend into adipose tissue. No in-situ tumour is identified.

DIAGNOSIS: Right x3 10 o'clock axilla: Invasive carcinoma NST.

Case Discussion

Any palpable lump should be worked up fully to exclude an abnormality, and this case also demonstrates the usefulness of extended CC lateral views in assessing the axillary tail. 

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Case information

rID: 43262
Case created: 3rd Mar 2016
Last edited: 24th Aug 2017
System: Breast
Inclusion in quiz mode: Included

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