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Atlas of breast cancer early detection
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Click on the pictures to magnify and display the legends| Case number: | 008 |
| Age: | 41 |
| Clinical presentation: | Premenopausal woman with average risk of breast cancer presented with a left breast lump. Examination revealed multiple small lumps in the left breast; the largest was 1.2 cm in diameter. |
Mammography:
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| Breast composition: | ACR category c (the breasts are heterogeneously dense, which may obscure small masses) | Mammography features: |
| ‣ Location of the lesion: | Left breast, upper inner quadrant at 11 o’clock, middle and posterior thirds |
| ‣ Mass: | |
| • Number: | 1 |
| • Size: | 2.0 × 1.0 cm |
| • Shape: | Oval |
| • Margins: | Circumscribed |
| • Density: | Equal |
| ‣ Calcifications: | |
| • Typically benign: | None |
| • Suspicious: | None |
| • Distribution: | None |
| ‣ Architectural distortion: | None |
| ‣ Asymmetry: | None |
| ‣ Intramammary node: | None |
| ‣ Skin lesion: | None |
| ‣ Solitary dilated duct: | None |
| ‣ Associated features: | None |
| Breast composition: | ACR category c (the breasts are heterogeneously dense, which may obscure small masses) | Mammography features: |
| ‣ Location of the lesion: | Right breast, upper outer quadrant at 10 o’clock, middle third |
| ‣ Mass: | |
| • Number: | 0 |
| • Size: | No |
| • Shape: | None |
| • Margins: | None |
| • Density: | None |
| ‣ Calcifications: | |
| • Typically benign: | Typically benign, round |
| • Suspicious: | None |
| • Distribution: | None |
| ‣ Architectural distortion: | None |
| ‣ Asymmetry: | None |
| ‣ Intramammary node: | None |
| ‣ Skin lesion: | None |
| ‣ Solitary dilated duct: | None |
| ‣ Associated features: | None |
Ultrasound:
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 |  |
| Ultrasound features: Left breast, upper inner quadrant at 10 o’clock | |
| ‣ Mass | |
| • Location: | Left breast, upper inner quadrant at 10 o’clock |
| • Number: | 1 |
| • Size: | 1.8 × 1.0 cm |
| • Shape: | Oval |
| • Orientation: | Parallel |
| • Margins: | Circumscribed |
| • Echo pattern: | Heterogeneous |
| • Posterior features: | Posterior Enhancement |
| ‣ Calcifications: | None |
| ‣ Associated features: | None |
| ‣ Special cases: | Complicated cyst |
| Ultrasound features: Left breast, central portion of the breast | |
| ‣ Mass | |
| • Location: | Left breast, central portion of the breast |
| • Number: | 1 |
| • Size: | 1.0 cm in greatest dimension |
| • Shape: | Oval |
| • Orientation: | Parallel |
| • Margins: | Circumscribed |
| • Echo pattern: | Anechoic |
| • Posterior features: | Posterior Enhancement |
| ‣ Calcifications: | None |
| ‣ Associated features: | None |
| ‣ Special cases: | Simple cyst |
BI-RADS:
BI-RADS Category: 2 (benign)Further assessment:
Further assessment advised: Referral for cytologyCytology:
 |
| Cytology features: | |
| ‣ Type of sample: | FNAC |
| ‣ Site of biopsy: | |
| • Laterality: | Left |
| • Quadrant: | Upper inner |
| • Localization technique: | Palpation |
| • Nature of aspirate: | 0.5 mL of yellowish clear fluid |
| ‣ Cytological description: | Plenty of foamy histiocytes and a few small clusters of benign ductal cells |
| ‣ Reporting category: | Benign |
| ‣ Diagnosis: | Fibrocystic change |
| ‣ Comments: | None |
Case summary:
| Premenopausal woman presented with left breast lump. Diagnosed as complicated cyst in left breast with fibrocystic changes in both breasts, BI-RADS 2 on imaging and as benign fibrocystic change on cytology. |
Learning points:
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