Breast cancer: malignant calcification on mammography

Case contributed by Dr Garth Kruger

Presentation

Routine screening.

Patient Data

Age: 40
Gender: Female

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

Mammography

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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Case information

rID: 21969
Case created: 2nd Mar 2013
Last edited: 11th May 2016
System: Breast
Inclusion in quiz mode: Included

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