Infiltrating ductal carcinoma of the breast

Case contributed by Garth Kruger
Diagnosis certain

Presentation

A 29 year old teacher complains of a new palpable lesion at 2 o'clock left breast.

Patient Data

Age: 29 years
Gender: Female

Breast

ultrasound

Ultrasound confirms a solid mass lesion at 2 o'clock left breast. 

Axilla

ultrasound

The axilla ultrasound shows a single non enlarged node measuring 15 x 6 mm.

Case Discussion

This turned out to be an infiltrating ductal carcinoma of the left breast. The FNA of the node was positive for malignant cells.

There are several teaching points in this case:

  1. This is not ever a fibroadenoma. It is poorly defined and has no pseudocapsule. Red flag. If it does not look like a fibroadenoma it probably isn't one.
  2. The parenchyma of the lesion is heterogeneous, a very unusual finding for a fibroadenoma. Red flag.
  3. The echogenicity of the node cortex is unusually high.

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