Breast cancer - malignant calcification (mammography)

Case contributed by Garth Kruger
Diagnosis almost certain


Routine screening.

Patient Data

Age: 40 years
Gender: Female

"Ground rock" calcifications in the central breast highly suggestive of DCIS.

Two years earlier


No suspicious calcifications, masses or architectural distortion. 

The calcifications are new and concerning. Ultrasound was performed. 

Solid mass at 12 o'clock radian of the right breast. The lesion has all the hallmarks of an infiltrating ductal carcinoma  (IDC).

The node is large and has a thick cortex.

Case Discussion

The mammogram shows DCIS right breast. The ultrasound adds value; imaging suggests an IDC and pathological node in the axilla. The biopsy of the mass and FNAC of the node confirmed IDC and lymph node metastatic cells.

It is practical and easy to add FNAC of an axilla. The procedure is generally well tolerated. The yield of cells is in general proportional to the number of needle passes. I use three separate 21G needles and pass them in turn repeatedly through the node and inject the yield into cytolyte. Same process as used in thyroid FNAC.

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