Presentation
Palpable lump.
Patient Data
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Asymmetric density seen in the right axillary region. No further suspicious mass, calcification or areas of architectural distortion.
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.
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Magnification coned compression views in MLO and CC confirm the presence of a spiculated mass.
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. Tumor 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. Tumor is seen to extend into adipose tissue. No in-situ tumor 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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