Presentation
Routine screening study
Patient Data
Note the small rounded density just below the equator of the breast.
Previously noted round density has increased in size.
This lesion was called a cyst. Birads 2 follow up in 1 year.
The lesion has further increased in size.
Lobulated, bizzare shaped hypoechoeic lesion with a thick wall.
Case Discussion
This is a biopsy confirmed lobular carcinoma of the breast.
This case has several teaching points:
1. Not all hypoechoic lesions are cysts.
2. A simple cyst should be simple. Look at the ultrasound carefully; this is not a simple cyst.
3. Beware of any developing lesions in the breast of a postmenopausal woman. It's a red flag.
The article in the reference is a very good summary of why lobular carcinomas are what they are and why we miss them.
Teaching point: not all hypoechoic structures in the breast are cysts. Compared with case 21370.
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