Developing density left breast

Case contributed by Dr Garth Kruger

Presentation

Screening mammogram of 2009 and follow up studies 2010, and 2013 with ultrasound.

Patient Data

Age: 60
Gender: Female
Mammography

No suspicious mass, architectural distortion or calcifications. 

Mammography

Note how the mass just obscures the profile of the pectoral muscle on the MLO view? Train your eye to run down the profile of the muscle on the MLO view.

Mammography

The study in 2013 is a diagnostic study. The IDC is now clinically palpable.

Ultrasound

Region of palpable abnormality

The lesion has all the hallmarks of a malignant lesion on ultrasound.

Note how deep the lesion is lying on the pectoral fascia. This is why a good CC view needs to be "good" and not just a CC view.

Case Discussion

"Time lapse" mammography to illustrate the development of an asymmetrical density in the left breast.

The teaching point: on a CC view you need to see the pectoral muscle centrally just intrude on the image or you will miss lesions deep in the breast. Like in this case.

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Case information

rID: 21708
Case created: 13th Feb 2013
Last edited: 11th May 2016
System: Breast
Inclusion in quiz mode: Excluded

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