Developing carcinoma left breast

Case contributed by Dr Garth Kruger


Routine mammography form 2009 to 2013.

Patient Data

Age: 60
Gender: Female

"Time lapse" mammography to illustrate the development of an infiltrating ductal carcinoma over a period of 4 years. Not all IDC present as a mass lesion. This case presents with progressive parenchymal symmetry with long slender "runners". This lesion is differentiated form a radial scar by the density centrally and with the appearance on ultraound. Contrast this case with the appearance of the radial scar

No abnormalities in 2009.


Very subtle asymmetry with "runners' developing. Seen on the MLO view not the CC view. Note the development of slender "runners" radiating form the small mass lesion?


The central density is visible in 2013 again with the spiculated periphery.  strangely best seen on the CC view this time.  Contrast the dense mass in the centre with the appearnce of a radial scar on mammography.


Lesion with spiculated margins.

Case Discussion

The object of this case is not  unthinking use of the  all seeing "retrospectoscope", an instrument has 6/6 vision on hindsight. The teaching point here is to allow you to look at a case and train your eye to observe and recall the spiculated "runners" that radiate from a small solid lesion. You can train your eye to spot the "runners" and lead it to the mass even in a dense breast. This is a skill that you can aquire with practice and effort.

If you are reading mammograms in a busy noisy, distracting, overlit environment, you will miss these lesions most of the time. You need to review mammograms in an environment that allows you to concentrate on what you are doing.  No phone.

PlayAdd to Share

Case information

rID: 21693
Case created: 12th Feb 2013
Last edited: 24th Dec 2016
System: Breast
Inclusion in quiz mode: Included

Updating… Please wait.

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.