Carcinoma right breast

Case contributed by Dr Garth Kruger

Presentation

A 55 year old female presents with a palpable mass right breast

Patient Data

Age: 50
Gender: Female

For educational purposes the layout for this case is slightly unconventional. The first two images are CC views of the right breast 2011 and 2012. Look at these two images thoughtfully first.

Modality: Mammography

Note the subtle increased density of the focal parenchymal density lateral to and behind the right nipple ?

Modality: Mammography

By 2013 the carcinoma is evident with skin thickening, nipple retraction and clearly visible on ultrasound.

Case Discussion

The teaching point is: malignant lesions do not have to grow to arouse suspicion. Increasing density in a lesion is also a red flag and deserves attention. Just because a lesion does not enlarge do not assume all is good. This case illustrates the point well.

Use a hanging protocol that allows you to compare density in the same image. Then once you are comfortable with this, change the protocol very couple of months  so you "refresh/reboot" your observation skills. If you stay with one hanging protocol for years your eyes get lazy. Try it; it works.

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Case Information

rID: 23700
Case created: 4th Jul 2013
Last edited: 12th Sep 2016
System: Breast
Inclusion in quiz mode: Included

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