Infiltrating pleiomorphic lobar carcinoma

Case contributed by Dr Valerio Giacalone


Patient undergoing annual mammography screening for early diagnosis.

Patient Data

Age: 60 years
Gender: Female

MX and CC mammography. A small parenchymal distortion is detected in the upper quadrants. This finding is not well visualized in the CC projection.

Ultrasound evaluation confirmed a hypoechogenic nodule with irregular margins of less than one centimeter.

Comparison with the previous mammogram one year ago. In the mammogram from a year earlier nothing abnormal was detectable. The ultrasound supplement from a year earlier was also negative for neoplasia.

Case Discussion

This case underlines the importance of annual screening for the early detection of breast cancer. 
Mammographic examination one year earlier was negative for suspicious neoplastic lesions.
The latest mammographic examination showed a suspicious lesion prominent only in the oblique projection of the upper quadrant. Ultrasound examination confirmed a small hypoechogenic nodule with irregular margins, showing a score of 5 on elastosonography: the general features were suspicious for neoplasia.
The patient underwent a biopsy, which confirmed bifocal infiltrating pleiomorphic lobular carcinoma.
The patient underwent a bi-quadrantectomy of the right breast.
She underwent radiotherapy and drug therapy.


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