Malignant breast calcification

Case contributed by Melbourne Uni Radiology Masters


Routine breast screening.

Patient Data

Age: 74-year-old
Gender: Female

Bilateral Mammography, including Tomography


Standard mammographic and tomographic views of both breasts have been supplemented with magnified coned compression views on the right side. A comparison has been made to the prior examination.

Irregular, highly suspicious microcalcification (Cat A) has developed in the inferomedial aspect of the right breast, extending over a distance of up to 3.8cm.

Elsewhere, stable scarring is seen in the upper outer quadrant of the left breast from prior surgery, without further suspicious focal mass, architectural distortion or microcalcification within either breast and elsewhere there has been no significant interval change when compared to the previous examination.

Conclusion: Highly suspicious (Cat A) microcalcification has developed in the lower inner quadrant of the right breast. Correlation with stereotactic guided core biopsy and carbon localization is recommended.


Case Discussion

MICROSCOPIC DESCRIPTION: Multiple core biopsies show a grade 2 invasive carcinoma comprising of nests, single files, trabeculae and tubules of epithelioid cells with moderately pleomorphic nuclei. There is a moderate number of mitoses (12/10hpf). Lymphovascular invasion is present. Tumor cells are ER+ (strong, 100%), PR+ (strong 100%), HER2- (1+), Ki67 30%, E-cadherin+.

DIAGNOSIS: R breast core biopsy, 1 o'clock 4cm from nipple: Invasive ductal carcinoma, grade 2, ER+, PR+, HER2-, Ki67 30%.

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