Tent sign of breast cancer

Case contributed by Giorgio M. Baratelli
Diagnosis certain

Presentation

Palpable lump.

Patient Data

Age: 60 years
Gender: Female
mammography

The craniocaudal view of the right breast showed a “V” shaped distortion of the posterior margin of the parenchyma.

Annotated image

The craniocaudal view of the right breast showed a “V” shaped distortion of the posterior margin of the parenchyma (the tent sign, indicated by the arrow).

Diagram

A retraction of the posterior border of the breast glandular tissue that is normally smooth and concave, may lead to a biconvex (a) or a straightened “V” shaped (b) border, resembling the peak of a tent.

Case Discussion

The craniocaudal view of the right breast showed a “V” shaped distortion of the posterior margin of the parenchyma ("tent sign"). Although the tumour was palpable, it was the only mammographic sign of malignancy.

The patient underwent a NAC skin-sparing mastectomy and immediate prosthetic breast reconstruction. The tumour was an invasive G2 lobular carcinoma of 5.8 cm in greatest dimension; 12 axillary lymph nodes were metastatic.

The tent sign accounts for a significant number of cancers missed by screening radiologists, for it may be the only mammographic sign of malignancy, and is usually seen only in one projection.

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