Go back to the list of case studies
                                                                                                                         Click on the pictures to magnify and display the legends

Case number:	018
Age:	56
Clinical presentation:	Postmenopausal woman presented with a lump in the right breast, which she had had for many years. She had an increased risk of developing breast cancer with family history of breast cancer. Examination revealed a firm 2 cm lump in the upper outer quadrant of the right breast.

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:	0
• Size:	None
• Shape:	None
• Margins:	None
• Density:	None
‣ Calcifications:
• Typically benign:	Coarse
• Suspicious:	None
• Distribution:	None
‣ Architectural distortion:	None
‣ Asymmetry:	None
‣ Intramammary node:	None
‣ Skin lesion:	None
‣ Solitary dilated duct:	None
‣ Associated features:	Calcifications

Breast composition:	ACR category b (there are scattered areas of fibroglandular density)
Mammography features:
‣ Location of the lesion:	Left breast, central portion of the breast, anterior third
‣ Mass:
• Number:	1
• Size:	1.5 × 1.3 cm
• Shape:	Oval
• Margins:	Circumscribed
• Density:	Equal
‣ Calcifications:
• Typically benign:	Popcorn-like
• Suspicious:	None
• Distribution:	Within mass
‣ Architectural distortion:	None
‣ Asymmetry:	None
‣ Intramammary node:	None
‣ Skin lesion:	None
‣ Solitary dilated duct:	None
‣ Associated features:	Calcifications

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:	1.8 × 1.0 cm
• Shape:	Oval
• Orientation:	Parallel
• Margins:	Circumscribed
• Echo pattern:	Hypoechoic
• Posterior features:	No posterior features
‣ Calcifications:	Present in mass
‣ Associated features:	None
‣ Special cases:	None

Ultrasound features: Left breast, central portion of the breast
‣ Mass
• Location:	Left breast, central portion of the breast
• Number:	1
• Size:	2.0 × 1.3 cm
• Shape:	Oval
• Orientation:	Parallel
• Margins:	Circumscribed
• Echo pattern:	Hypoechoic
• Posterior features:	Posterior shadowing
‣ Calcifications:	Present in mass
‣ Associated features:	None
‣ Special cases:	None

BI-RADS:

BI-RADS Category: 2 (benign)

Case summary:

Postmenopausal woman presented with right breast lump. Diagnosed as involuting (partially calcified) fibroadenoma in both breasts, BI-RADS 2 on imaging.

Learning points:

Involuting fibroadenoma contains coarse or popcorn-like macrocalcification, which makes the lesion a hard palpable lump. No further assessment is needed.