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

Case number:	137
Age:	41
Clinical presentation:	Premenopausal woman with average risk of developing breast cancer presented with a history of left mastalgia.

Mammography:

Breast composition:	ACR category d (the breasts are extremely dense, which lowers the sensitivity of mammography)
Mammography features:
‣ Location of the lesion:	None
‣ Mass:
• Number:	0
• Size:	None
• Shape:	None
• Margins:	None
• Density:	None
‣ 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

BI-RADS:

BI-RADS Category: 1 (negative)

Case summary:

Premenopausal woman with average risk of developing breast cancer presented for mammography screening. Diagnosed as BI-RADS 1 on imaging.

Learning points:

The sensitivity of mammography in younger premenopausal women may be limited, as the breast parenchyma is dense under the cyclical influence of estrogen. The diagnostic mammogram is performed to rule out obvious architectural distortion or suspicious mass, though small mass lesions may be hidden within the dense breast parenchyma.