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Atlas of breast cancer early detection

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Case number:090
Clinical presentation:Premenopausal woman with average risk of developing breast cancer presented with pain in the right breast. Examination revealed a lump measuring 1.5 cm in diameter in the right upper outer quadrant.


Ultrasound features: Right breast, upper outer quadrant, 10 o’clock in axillary tail

 ‣ Mass
   • Location:Right breast, upper outer quadrant, 10 o’clock in axillary tail
   • Number:1
   • Size:1.7 × 1.0 cm
   • Shape:Irregular
   • Orientation:Not parallel
   • Margins:Angular
   • Echo pattern:Hypoechoic
   • Posterior features:No posterior features
 ‣ Calcifications:None
 ‣ Associated features:Peripheral vascularity and vessels in rim
 ‣ Special cases:None


BI-RADS Category: 2 (benign)

Further assessment:

Further assessment advised: Referral for cytology


Cytology features:

 ‣ Type of sample:FNAC (solid lesion)
 ‣ Site of biopsy:
   • Laterality:Right
   • Quadrant:Upper outer
   • Localization technique:Palpation
   • Nature of aspirate:2 mL of purulent yellowish white material
 ‣ Cytological description:Smears show plenty of neutrophils admixed with a few lymphocytes on a necrotic background
 ‣ Reporting category:Benign
 ‣ Diagnosis:Acute inflammation and breast abscess
 ‣ Comments:None

Case summary:

Premenopausal woman presented with right breast pain. Diagnosed as inflammatory lesion in right breast, BI-RADS 2 on imaging and as acute inflammation, breast abscess on cytology.

Learning points:

  • Inflammatory lesions can mimic the morphological features of malignancy, such as an irregular mass with spiculated margins. Triple assessment will confirm the diagnosis and follow-up reveals complete resolution of the inflammatory lesion.

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