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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: | 006 |
| Age: | 48 |
| Clinical presentation: | Premenopausal woman with average risk of breast cancer presented with a recent-onset left breast lump in the upper quadrant. Examination revealed a firm 8 cm lump in the upper half of the left breast. |
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 quadrants at 12 o’clock, anterior and middle thirds |
| ‣ Mass: | |
| • Number: | Multiple |
| • Size: | Largest 4.5 × 3.0 cm |
| • Shape: | Oval |
| • Margins: | Obscured |
| • 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, all quadrants, entire breast, anterior and middle thirds |
| ‣ Mass: | |
| • Number: | Multiple |
| • Size: | Largest 1.8 × 1.5 cm |
| • Shape: | Oval |
| • Margins: | Obscured |
| • 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 |
Ultrasound:
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| Ultrasound features: Left breast, central portion of the breast at 12 o’clock | |
| ‣ Mass | |
| • Location: | Left breast, central portion of the breast at 12 o’clock |
| • Number: | Multiple |
| • Size: | Largest 4.5 × 3.0 cm |
| • Shape: | Oval |
| • Orientation: | Parallel |
| • Margins: | Circumscribed |
| • Echo pattern: | Anechoic with internal echoes |
| • Posterior features: | Posterior Enhancement |
| ‣ Calcifications: | None |
| ‣ Associated features: | None |
| ‣ Special cases: | Simple cyst and complicated cyst |
| Ultrasound features: Right breast, central portion of the breast at 12 o’clock | |
| ‣ Mass | |
| • Location: | Right breast, central portion of the breast at 12 o’clock |
| • Number: | Multiple |
| • Size: | Largest 1.8 × 1.0 cm |
| • 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: | 12 o’clock |
| • Localization technique: | Palpation |
| • Nature of aspirate: | 0.2 mL of yellowish fluid |
| ‣ Cytological description: | Smear shows a few monolayered sheets of benign ductal epithelial cells with a few macrophages |
| ‣ Reporting category: | Benign |
| ‣ Diagnosis: | Proliferative fibrocystic change |
| ‣ Comments: | None |
Case summary:
| Premenopausal woman presented with recent-onset left breast lump. Diagnosed as complicated cyst, BI-RADS 2 on imaging and as proliferative fibrocystic change on cytology. Multiple simple cysts were also noted in both breasts on imaging. |
Learning points:
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