Subareolar infiltrating ductal breast cancer

Case contributed by Garth Kruger
Diagnosis certain


Palpable mass under the left areola

Patient Data

Age: 30 years
Gender: Female

I have left the annotation on the image to confirm where the image was taken. The study was initially interpreted as normal. The acoustic shadow under the nipple is a potential hazard in interpretation. Don't simply assume there is a shadow from their nipple. If you look carefully you will see a mass subareolar with microcalcifications.

Breast ultrasound is a hands on real time imaging study.

Subareolar mass with calcifications.

Case Discussion

This is an exceptional invasive ductal carcinoma in a 30 year old lady with no family history.

The teaching points here are:

  1. The subareolar acoustic shadow is a potential hiding place for mass lesions. It's too simple to assume that the area is blind in ultrasound.
  2. Breast ultrasound is a hands on real time imaging procedure.
  3. Subareolar imaging is best done from an oblique angle with pressure on the probe.

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