Left breast mass - BIRADS 5

Case contributed by Mellanie Deborah

Presentation

Patient with history of ultrasound BIRADS 3 nodule in left breast (3 years before the current study). She recently noticed growth of the nodule and retraction of the skin.

Patient Data

Age: 45 years
Gender: Female

Diagnostic mammogram

Mammography

Scattered fibroglandular tissue on both breasts. LCC view partially shows a nodular lesion with irregular shape and spiculated margins in the most posterior aspect of external quadrants, in concordance with palpable lesion. XLCCL view helps demonstrate the lesion in its entirety and to see its margins more clearly. LMLO view confirms the lesion is in the upper exterior quadrant of the breast, and additionally there are several enlarged lymph nodes in the left axillary area.

Spiculated nodule in left breast in association with skin retraction and axillary adenopathy: BIRADS 5

Left nodule progression

Mammography

Screening mammogram LMLO view showed a small nodular lesion with undefined margins in the left upper quadrant of the breast, no adenopathies. ​3 years later, the lesion has grown considerably, from 10 mm to 31 mm, it has spiculated margins and there's presence of skin retraction and axillary adenopathy.

Case Discussion

This lesion was initially characterized as a mammographic BIRADS 0 lesion, and after further exploration with ultrasound, it was characterized as a BIRADS 3 lesion. The patient was not called back for her 6-month ultrasound check-up and only got a mammography referral several years later, when she noticed skin retraction.

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