Infiltrating ductal arcinoma of the breast

Case contributed by Dr Mohammad A. ElBeialy

Presentation

Right breast lump for a month.

Patient Data

Age: 40 years
Gender: Female
  • predominantly fatty parenchyma with scattered glandular elements of both breasts (ACRI).
  • the upper outer segment of the right breast shows a partially ill-defined globular dense mass lesion with some obscuration of its margin and infiltration of the surrounding parenchyma and architectural distortion. The lesion measures 3.5 X 3 cm.
  • no masses seen in the left breast.
  • no suspicious clusters of micro-calcifications seen.
  • normal contour and skin thickness of either breasts as well as  both nipple/areolar complexes.
  • no enlarged axillary lymph node.

Ultrasonographic examination showed:

  • the upper outer quadrant of the right breast (10 O’clock position) shows a lobulated with irregular angular margins heterogeneously hypoechoic mass lesion measuring about 3 X 2 cm in its maximal dimensions. It shows mixed posterior acoustic enhancement and shadowing. The lesion is oriented more vertically and deeper than wide with focal architectural distortion.
  • no left breast or axillary masses.
  • no ductectasia.

Case Discussion

Infiltrating ductal carcinoma grade II was revealed in excisional biopsy and histopathological examination. 

BIRADS scoring is the breast imaging and reporting data system for classifying the radiological diagnosis of breast lesions:

  • BIRADS 0: needs further investigations (0%)
  • BIRADS 1: normal findings (0%)
  • BIRADS 2: definitely benign
  • BIRADS 3: probably benign (2%)
  • BIRADS 4: probably malignant (50%)
  • BIRADS 5: malignant (98-100%)
  • BIRADS 6: proven pathologically malignant

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