Breast cancer - BI-RADS 5

Case contributed by Mohammadtaghi Niknejad


Left breast palpable mass on physical exam.

Patient Data

Age: 40 years
Gender: Female

A large, partially obscured mass is seen in the left breast's central portion and upper outer quadrant. Irregularity is present in visualised part of mass borders, and a few small calcified foci could be seen within. Mild skin thickening is also observed in peri nipple regions.

In addition, several prominent lymph nodes are seen in the left axillary regions.

A tomosynthesis was performed for better evaluation of the mentioned partially obscured mass.



In the tomosynthesis evaluation of the left breast, the mass shows irregular and spiculated margins accompanied by adjacent parenchymal distortion highly suspicious of malignancy. (BI-RADS 5)


The patient underwent an ultrasound-guided core needle biopsy.

Tumoural cells infiltrate breast tissue in the pattern of sheets, small clusters, cords and tubular formation. Ducts filled by uniform cells with prominent cell borders. Central expansile necrosis is evident. Ductal carcinoma in situ accompanied by small foci of calcification is also observed.

Diagnosis: invasive breast carcinoma of no special type

Pathologist: Dr Shiva Mohajeri

Case Discussion

In the case of obscured masses on 2D mammography, further evaluation with tomosynthesis could be helpful for better characterisation of borders.

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