Carcinoma right breast

Case contributed by Dr Garth Kruger

Presentation

Routine screening study

Patient Data

Age: 45
Gender: Female
Modality: Mammography

Note the 14 mm spiculated lesion overlying the profile of the right pectoral muscle.

Modality: Mammography

You don't see the lesion.

Modality: Ultrasound

Another case to illustrate how important it is to review the profile of the pectoral muscle on the MLO view.

IDC right breast

Case Discussion

This case illustrates two points:

1. This is why we do MLO instead of ML views for mammography. You see so much more of the breast volume  on the MLO view.  A mammogram is a two dimensional view of a three dimensional structure; the same way a flat  map is a relatively poor replica of the earth's surface (http://www.eoearth.org/article/Maps).  MLO and CC shows more tissue volume than orthogonal views.

You know the lesion is low, deep in the breast because its not on the ML view. Its at 7 o'clock

2. Check the profile of the pectoral muscle on the MLO view and you will find these lesions early in spite of the dense breast parenchyma of this young patient.

On biopsy this lesion was clearly palpable with skin retraction and focal thickening. The patient never noticed an abnormality.

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Case Information

rID: 22386
Case created: 29th Mar 2013
Last edited: 22nd Jan 2016
System: Breast
Inclusion in quiz mode: Included

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