Presentation
Routine MLO views two years apart, right breast.
Patient Data
Screening mammogram appearing normal.
A small density has appeared over the profile of the pectoral muscle.
Ultrasound images of small cancer deep in the right breast parenchyma.
Case Discussion
As mentioned before, the submammary fat is a review area on breast imaging. This case also demonstrates the value of previous images for comparison. The profile of the pectoral muscle must be pristine and uninterrupted on the MLO view.
Golden rule: always look at previous imaging.
One more: breast ultrasound is a hands-on procedure. Do it in real-time with your own eyes or get bitten.
Last one: screening studies need to be read in an uninterrupted environment free of phones.