Synchronous bilateral breast cancer

Case contributed by Dr Valerio Giacalone


The patient had palpated two hard lumps, one in the right breast and one in the left breast.

Patient Data

Age: 70 years
Gender: Female

Ultrasound examination shows a nodule to the right of the QSM with a hypoechoic structure and irregular margins. On the left, in the periareolar area, another nodule with spiculate margins is observed. Both nodules show a high "relationship" with elastosonography, synonymous with "tissue stiffness".


Nodule with irregular margins on the right QSM; nodule with spiculate margins in the left inferior periareolar site.

Case Discussion

Mammography shows the presence of two nodules, one on the left with spiked margins, with clear features of malignancy (BI-RADS IV), and one on the right radiopaque with irregular margins.

The ultrasound examination confirms the presence of two nodules that showed a high “score” on elastosonography (BI-RADS IV).

The only ultrasound examination of the right lump without mammography and elastosonography correlation could be interpreted as a benign lesion.

The appearance of the left nodule was instead representative of malignant neoformation both on mammography and ultrasound.

After the biopsy, the histological diagnosis mentioned mucinous adenocarcinoma on the right and infiltrating ductal tumor on the left.

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