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Case number:	025
Age:	44
Clinical presentation:	Premenopausal woman with average risk of developing breast cancer presented with cyclical mastalgia in both breasts. On examination, nodularity in the outer quadrant of the right breast was noted.

Mammography:

Breast composition:	ACR category b (there are scattered areas of fibroglandular density)
Mammography features:
‣ Location of the lesion:	Right breast, upper outer quadrant at 10 o’clock, middle third
‣ Mass:
• Number:	1
• Size:	0.9 cm in greatest dimension
• Shape:	Oval
• Margins:	Circumscribed
• Density:	Equal
‣ Calcifications:
• Typically benign:	None
• Suspicious:	None
• Distribution:	None
‣ Architectural distortion:	None
‣ Asymmetry:	None
‣ Intramammary node:	Present
‣ Skin lesion:	None
‣ Solitary dilated duct:	None
‣ Associated features:	None

Ultrasound:

Ultrasound features: Right breast, upper outer quadrant at 10 o’clock
‣ Mass
• Location:	Right breast, upper outer quadrant at 10 o’clock
• Number:	1
• Size:	0.9 cm in greatest dimension
• Shape:	Oval
• Orientation:	Parallel
• Margins:	Circumscribed
• Echo pattern:	Hypoechoic with central sinus
• Posterior features:	No posterior features
‣ Calcifications:	None
‣ Associated features:	Hilar vascularity
‣ Special cases:	Lymph nodes, intramammary

BI-RADS:

BI-RADS Category: 2 (benign)

Case summary:

Premenopausal woman presented with bilateral cyclical mastalgia and right breast outer quadrant nodularity. Diagnosed as intramammary node in right breast, BI-RADS 2 on imaging.

Learning points:

Intramammary nodes are seen in the lateral half of the breast. This is a mammography finding of no concern, but it is important to mention it in the report so as to make a note of the presence of the nodes. On follow-up mammogram, there is no false alarm or any concern raised with this density in the outer quadrant of the breast.