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Atlas of breast cancer early detection

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Case number:156
Age:54
Clinical presentation:Postmenopausal woman with average risk of developing breast cancer presented for mammography screening. CBE revealed no significant findings.


Mammography:


Breast composition:ACR category a (the breasts are almost entirely fatty)
Mammography features:

 ‣ Location of the lesion:Right breast, upper outer quadrant at 10 o’clock, posterior third
 ‣ Mass:
   • Number:1
   • Size:1.1 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:0.7 cm in greatest dimension
   • Shape:Oval
   • Orientation:Not 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:

Postmenopausal woman with average risk of developing breast cancer came for mammography screening. Diagnosed as intramammary node in the right breast, BI-RADS 2 on imaging.

Learning points:


  • Intramammary nodes are one of the most commonly seen benign findings in mammograms. They appear as opacities with circumscribed margins and lucent central hilum in the outer quadrant of the breast, but can occur in other parts of the breast.
  • They are a common visible recognizable finding in approximately 5% of mammograms.
  • Their appearance is characteristic and does not require further investigation.

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