Presentation
Routine annual check up which included a mammogram.
Patient Data
The mammography revealed bulky, predominantly fatty breasts with a tiny suspicious lesion in the right breast. Spot magnification revealed a spiculated mass.
Ultrasound revealed a small irregular hypoechoic lesion at the 9 o'clock position. The lesion looked highly suspicious for malignancy. A final diagnosis of a BIRADS category 5 lesion was given.
Since the lesion was not palpable, an ultrasound-guided wire localization was done followed by excision.
Check mammogram with wire in situ.
Specimen mammography demonstrates hookwire and mass in situ.
Case Discussion
Mammography is very sensitive in case of fatty breasts as was found in this case. Even a subcentimeter lesion was detected on the initial mammogram. Spot magnification added to further characterization of the lesion.
A wire localization, in this case, helped the surgeon in performing a successful lumpectomy without having to remove an entire quadrant.
Histopathology confirmed high-grade ductal carcinoma.
The smaller the carcinoma, the better the prognosis. In this case an early diagnosis in an absolutely asymptomatic patient improved her chances of a better survival.
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