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Atlas of breast cancer early detection

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Case number:146
Clinical presentation:Premenopausal woman with average risk of developing breast cancer presented with bilateral cyclical mastalgia. Examination did not reveal any lump or palpable lesion.


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 Category: 1 (negative)

Case summary:

Premenopausal woman presented with bilateral cyclical mastalgia. Diagnosed as BI-RADS 1 on imaging.

Learning points:

  • Premenopausal women with fibrocystic changes in the breast commonly present with bilateral mastalgia. Imaging is performed to rule out obvious features of breast cancer or inflammation, although extremely dense breast parenchyma limits the sensitivity.

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