Invasive ductal carcinoma in left breast

Case contributed by Shervin Sharifkashani
Diagnosis certain

Presentation

Follow-up and staging of left breast invasive ductal carcinoma.

Patient Data

Age: 45 years
Gender: Female

Solid mass with mild to the moderate enhancement and relatively lobulated and ill-defined and also partly spiculated margin and size up to 38mm in left breast upper-outer quadrant is seen. Multiple and significantly enlarged suspicious lymph nodes SAD up to 22mm in the left axillary fossa are seen. Note also the diffuse skin thickening in the left breast.

There are histology and IHC reports of the left breast mass lesion which indicate ER(-), PR(-), and HER2(+) invasive ductal carcinoma.

Case Discussion

The case illustrates breast invasive ductal carcinoma and axillary metastatic lymph nodes on contrast-enhanced MDCT. The best imaging modality for breast cancer screening is mammography and for axillary fossa lymph nodes is an ultrasound exam. The contrast-enhanced chest, abdomen, and pelvic MDCT are useful for metastasis evaluation. . MRI of the breast especially dynamic contrast-enhanced MRI has also some indications, for example, in case of detected axillary metastatic lymph nodes and normal breast on both ultrasound and mammography exams. The role of MRI in staging and follow-up of breast cancer patients is evolving.

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