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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.

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