Breast carcinoma

Case contributed by Melbourne Uni Radiology Masters

Presentation

Left breast lump, new clinical finding.

Patient Data

Age: 56-year-old
Gender: Female

Standard mammographic views

mammography

Within the upper outer quadrant of the left breast there is a spiculated, irregular mass associated with indeterminate microcalcification. The right breast is unremarkable.

Workup mammographic views

mammography

Workup Mammographic views demonstrate the spiculated, ill-defined margins of the mass, with malignant mammographic features. The associated microcalcification is indeterminate.

Targeted ultrasound left breast

ultrasound

In the left breast 1 o'clock, 7 cms from the nipple there is an irregular, hypoechoic mass with an echogenic rind which disrupts tissue planes and has malignant sonographic features. It corresponds to the mammographic finding. Ultrasound of the left axilla is normal.

 

ultrasound

Ultrasound guided core biopsy.

Ultrasound was used to guide biopsy of the highly suspicious mass in the 1 o clock position of the left breast and images confirm good needle position. 

Specimen X-ray Left Breast

Specimen Xrays confirm the presence of the mammographic abnormality to lie within the specimens.

Case Discussion

MACROSCOPIC DESCRIPTION: "Left breast 1 o'clock, 7cm FN": Four cores 30mm in total length. A1. 

MICROSCOPIC DESCRIPTION: Sections show multiple cores of breast parenchyma which shows an invasive carcinoma with morphological features in keeping with a BRE grade 2 tumor.

DIAGNOSIS: Left breast 1 o'clock 7cm FN: Invasive carcinoma NST. SUPPLEMENTARY REPORT : INVASIVE CARCINOMA Estrogen receptor POSITIVE Staining intensity strong % tumor cells >90 Progesterone receptor POSITIVE Staining intensity strong % tumor cells 60 HER-2 score 0

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