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Atlas of breast cancer early detection

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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.


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