Invasive breast carcinoma

Case contributed by Arlene Mou


Screening study.

Patient Data

Age: 60 years
Gender: Female

Screening mammogram

Standard mammographic views of both breasts demonstrate a non specific density in the upper, outer right breast. Workup mammography including coned, compression magnification views in the MLO and CC projections should be performed.

Workup mammography

Workup views confirm persistence (absence of dispersion) of non specific density right upper, outer quadrant. The non specific density has indeterminate features. Diagnostic ultrasound is recommended.

Right breast ultrasound

Ultrasound of the right breast confirms a small, spiculated, irregular, heterogeneous (mixed hyper and hypoechoic) mass with malignant sonographic features. Note irregular margin, disruption of tissue planes and echogenic rind but absence of shadowing and "taller than wide" feature. It lies in the 10 o'clock position of the right breast. It corresponds in size and position to the mammographic abnormality. Screening ultrasound of the remainder of the right breast reveals no further focal abnormality. Screening ultrasound of the right axilla reveals no suspicious axillary lymph nodes. Ultrasound guided core biopsy and carbon localization of the mass is recommended.

Case Discussion

Core biopsy histopathology: Sections show multiple cores of breast parenchyma which has morphological features in keeping with a BRE grade I invasive carcinoma.

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