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Atlas of breast cancer early detection

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Case number:014
Age:59
Clinical presentation:Postmenopausal woman with average risk of developing breast cancer presented with a large painless lump of long duration in her right breast. Examination revealed a soft to firm lump in the right breast.


Mammography:


Breast composition:ACR category b (there are scattered areas of fibroglandular density)
Mammography features:

 ‣ Location of the lesion:Right breast, lower quadrants at 4–8 o’clock, middle and posterior thirds
 ‣ Mass:
   • Number:1
   • Size:11.0 × 5.0 cm
   • Shape:Oval
   • Margins:Circumscribed
   • Density:Fat-containing
 ‣ 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:


Ultrasound features: Right breast, lower quadrants at 4–8 o’clock

 ‣ Mass
   • Location:Right breast, lower quadrants at 4–8 o’clock
   • Number:1
   • Size:10.5 × 4.5 cm
   • Shape:Oval
   • Orientation:Parallel
   • Margins:Circumscribed
   • Echo pattern:Isoechoic
   • Posterior features:No posterior features
 ‣ Calcifications:None
 ‣ Associated features:None
 ‣ Special cases:None

BI-RADS:

BI-RADS Category: 2 (benign)

Further assessment:

Further assessment advised: Referral for cytology

Cytology:

Cytology features:

 ‣ Type of sample:FNAC
 ‣ Site of biopsy:
   • Laterality:Right
   • Quadrant:Lower half
   • Localization technique:Palpation
   • Nature of aspirate:Greasy and fatty
 ‣ Cytological description:Smears show mature adipose tissue strands
 ‣ Reporting category:Benign
 ‣ Diagnosis:Consistent with lipoma
 ‣ Comments:None


Case summary:

Postmenopausal woman presented with painless right breast lump of long duration. Diagnosed as lipoma, BI-RADS 2 on imaging and as lipoma on cytology.

Learning points:



  • Lipoma is the most common benign mesenchymal tumor to occur in the breast. When normal glandular structures are incorporated within the substance of a lipoma, the term adenolipoma is used.


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