Infiltrating ductal carcinoma

Case contributed by Dr Henry Knipe

Presentation

Routine screening.

Patient Data

Age: 53
Gender: Female
Modality: Mammography

Right breast - cluster of pleomorphic calcifications in the right upper outer quadrant seen on the MLO view only. 

Modality: Mammography

Calcifications appear unchanged and do not layer. 

This lesion was given a category A and a stereotactic biopsy was performed. 

MACROSCOPIC DESCRIPTION: "Right breast calcs UOQ Cat A": Several cores of cream and yellow tissue 22x16x3mm in aggregate. A1. 

MICROSCOPIC DESCRIPTION: The cores of breast parenchyma shows several dilated ducts with intermediate and high grade ductal carcinoma in situ of cribriform and micropapillary type with microcalcification. DCIS is not associated with necrosis. Infequent stromal microcalcifications are also present. In addition, there is a focus of infiltrating carcinoma NST 1.7mm in maximum dimension. No myoepithelial cells are demonstrated in immunostains. The cells are arranged in sheets and nests, with no tubule formation. Nuclei are moderately irregular and have small nucleoli. There are only rare mitoses. In immunostains, there is strong staining for oestrogen receptors in >95% of the tumour cell nuclei, no staining for progestogen receptors and no complete membrane staining for HER-2 (score 0). About 30% of the cells are Ki67+.

DIAGNOSIS: Right breast calcifications UOQ: Infiltrating carcinoma NST, BRE grade 2, ER+, PR+, HER-2-, with high grade ductal carcinoma in situ.

Case Discussion

This case demonstrates invasive ductal carcinoma that presents as suspicious calcifications only without an associated mass. 

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Case Information

rID: 38305
Case created: 14th Jul 2015
Last edited: 7th Sep 2015
System: Breast
Inclusion in quiz mode: Included

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