High-grade ductal carcinoma
50 year old female came for routine annual check up which included a mammogram.
The mammography revealed bulky, predominantly fatty breasts with a tiny suspicious lesion in the right breast. Spot magnification revealed a spiculated mass
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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 localisation was done followed by excision.
Histopathology confirmed high grade ductal carcinoma.
Mammography is very sensitive in case of fatty breasts as was found in this case. Even a sub centimeter lesion was detected on the initial mammogram. Spot magnification added to further characterization of the lesion.
A wire localisation in this case helped the surgeon in performing a successful lumpectomy without having to remove an entire quadrant.
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.