Triple negative breast cancer

Case contributed by Ahmed Abdelrahman

Presentation

Palpable left breast mass during self-examination. No skin changes noted. She has a family history of breast cancer.

Patient Data

Age: 50 years
Gender: Female
mammography

Round partially circumscribed mass of intermediate density with no related calcifications seen in the left breast near the axillary region.

ultrasound

A rounded well defined hypoechoic mass with posterior acoustic enhancement with no appreciable internal vascularity seen at 1 o'clock of the left breast.

mri

A well-defined rounded mass, hypointense in T1 and T2, with restricted diffusion is seen in the left upper quadrant towards the axilla in close vicinity to the underlying pectoralis muscle with no MRI evidence of invasion. In the contrast-enhanced studies, it shows annular enhancement with type 2 curve. No skin thickening, parenchymal distortion, or suspicious axillary lymphadenopathy.

Case Discussion

Triple negative breast cancer (TNBC) is type of malignant breast lesions, commonly occurring in young women. Its name comes from the fact that the cells lack the receptors of estrogen, progesterone and HER2 protein 1.

Small lesions (< 2 cm) can be tricky on ultrasound and mammography mimicking benign lesions like fibroadenoma. TNBC tumors tend to show more suspicious ultrasound features and greater tumor roundness than fibroadenomas 1

MRI will show the rim enhancement which is an MRI feature of malignant breast lesions 2.  

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