Lobular carcinoma left breast

Case contributed by Garth Kruger


Routine screening study

Patient Data

Age: 70 years
Gender: Female

Note the small rounded density just below the equator of the breast.

Mammogram done 6 months later


Previously noted round density has increased in size. 

Ultrasound done 6 months later


This lesion was called a cyst. Birads 2 follow up in 1 year.

Mammogram done 1 year later


The lesion has further increased in size.

Ultrasound done 1 year later


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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