Presentation
Palpable lump.
Patient Data
The craniocaudal view of the right breast showed a “V” shaped distortion of the posterior margin of the parenchyma.
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).
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 tumor was palpable, it was the only mammographic sign of malignancy.
The patient underwent a NAC skin-sparing mastectomy and immediate prosthetic breast reconstruction. The tumor 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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