Lobular carcinoma left breast
Routine screening mammogram
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Subtle parenchymal density deep in the breast just medial of the breast equator.
This density was on two previous mammograms. It had increased slightly in volume. Workup showed an ultrasound visible mass: diagnosis lobular carcinoma.
Do not leave these densities without workup. Compare with the earliest mammogram available. These lobular cancers can show little change year on year.
We know we miss lobular cancers in large series of screening studies. They do not behave like the typical IDC, very little scirrhous reaction and the asymmetry in density can be really subtle. A high index of suspicion is key.