Subareolar intraductal carcinoma

Case contributed by Garth Kruger

Presentation

Palpable mass lesion 6 months after a "normal" screening mammogram

Patient Data

Age: 40 years
Gender: Female

Initial mammogram

mammography

Normal CC view of left breast was read as normal.

Two years later

mammography

Two years later and 6 months before the left breast ultrasound below, this CC view was read as normal. The subareolar breast tissue is a review area. Its dangerous to assume that developing densities here are simply because the nipple is not in profile....

6 months after

ultrasound

6 months later the patient feels the IDC under her left nipple. Do conscious review of the subareolar breast tissue. It becomes really important in denser breasts.

Case Discussion

Ultrasound of the subareolar breast can be tricky. The acoustic shadow from the nipple can potentially mask a lesion directly deep to the nipple. Angling the probe to "peer" behind the nipple is a useful technique but most importantly of all, it is essential the ultrasound tech knows what he/she is looking for and where it is located.

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