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Atlas of breast cancer early detection
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BI-RADS Category (at follow-up (2017)): 2 (benign)
BI-RADS Category (at follow-up (2018)): 2 (benign)
Click on the pictures to magnify and display the legends| Case number: | 161 |
| Age: | 44 |
| Clinical presentation: | Premenopausal woman with increased risk of breast carcinoma because of family history of breast cancer presented in 2012 for screening. CBE did not reveal any abnormality. |
Mammography:
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| Breast composition: | ACR category c (the breasts are heterogeneously dense, which may obscure small masses) | Mammography features: |
| ‣ Location of the lesion: | 2012: Right breast, upper inner quadrant at 1 o’clock, middle third |
| ‣ Mass: | |
| • Number: | 1 |
| • Size: | 1.8 × 1.0 cm |
| • Shape: | Oval |
| • Margins: | Partly circumscribed and partly indistinct |
| • Density: | Equal |
| ‣ Calcifications: | |
| • Typically benign: | None |
| • Suspicious: | Suspicious calcifications |
| • Distribution: | Grouped, > 5 in number, in < 2.0 cm of breast tissue |
| ‣ Architectural distortion: | None |
| ‣ Asymmetry: | None |
| ‣ Intramammary node: | None |
| ‣ Skin lesion: | None |
| ‣ Solitary dilated duct: | None |
| ‣ Associated features: | None |
| Mammography features: | |
| ‣ Location of the lesion: | 2012: Left breast, upper inner quadrant at 10 o’clock, posterior third |
| ‣ Mass: | |
| • Number: | 0 |
| • Size: | None |
| • Shape: | None |
| • Margins: | None |
| • Density: | None |
| ‣ Calcifications: | |
| • Typically benign: | None |
| • Suspicious: | None |
| • Distribution: | Single macrocalcification focus |
| ‣ Architectural distortion: | None |
| ‣ Asymmetry: | None |
| ‣ Intramammary node: | None |
| ‣ Skin lesion: | None |
| ‣ Solitary dilated duct: | None |
| ‣ Associated features: | None |
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 |  |
| Breast composition: | ACR category b (there are scattered areas of fibroglandular density) | Mammography features: |
| ‣ Location of the lesion: | 2017: Follow-up at year 5: Right breast, upper inner quadrant at 1 o’clock, middle third |
| ‣ Mass: | |
| • Number: | 1 |
| • Size: | 1.7 × 1.0 cm |
| • Shape: | Oval |
| • Margins: | Partly circumscribed and partly indistinct |
| • Density: | Equal |
| ‣ Calcifications: | |
| • Typically benign: | Coarse macrocalcifications |
| • Suspicious: | None |
| • Distribution: | In mass |
| ‣ Architectural distortion: | None |
| ‣ Asymmetry: | None |
| ‣ Intramammary node: | None |
| ‣ Skin lesion: | None |
| ‣ Solitary dilated duct: | None |
| ‣ Associated features: | None |
| Breast composition: | ACR category b (there are scattered areas of fibroglandular density) | Mammography features: |
| ‣ Location of the lesion: | 2017: Follow-up at year 5: Left breast, upper inner quadrant at 10 o’clock, posterior third |
| ‣ Mass: | |
| • Number: | 0 |
| • Size: | None |
| • Shape: | None |
| • Margins: | None |
| • Density: | None |
| ‣ Calcifications: | |
| • Typically benign: | None |
| • Suspicious: | None |
| • Distribution: | Single macrocalcification focus |
| ‣ Architectural distortion: | None |
| ‣ Asymmetry: | None |
| ‣ Intramammary node: | None |
| ‣ Skin lesion: | None |
| ‣ Solitary dilated duct: | None |
| ‣ Associated features: | None |
 |  |
 |  |
| Breast composition: | ACR category b (there are scattered areas of fibroglandular density) | Mammography features: |
| ‣ Location of the lesion: | 2018: Follow-up at year 6: Right breast, upper inner quadrant, 1 o’clock, middle third |
| ‣ Mass: | |
| • Number: | 1 |
| • Size: | 1.7 × 1.0 cm |
| • Shape: | Oval |
| • Margins: | Partly circumscribed and partly indistinct |
| • Density: | Equal |
| ‣ Calcifications: | |
| • Typically benign: | Coarse macrocalcifications |
| • Suspicious: | None |
| • Distribution: | In mass |
| ‣ Architectural distortion: | None |
| ‣ Asymmetry: | None |
| ‣ Intramammary node: | None |
| ‣ Skin lesion: | None |
| ‣ Solitary dilated duct: | None |
| ‣ Associated features: | None |
| Breast composition: | ACR category b (there are scattered areas of fibroglandular density) | Mammography features: |
| ‣ Location of the lesion: | 2018: Follow-up at year 6: Left breast, upper inner quadrant at 10 o’clock, posterior third |
| ‣ Mass: | |
| • Number: | 0 |
| • Size: | None |
| • Shape: | None |
| • Margins: | None |
| • Density: | None |
| ‣ Calcifications: | |
| • Typically benign: | None |
| • Suspicious: | None |
| • Distribution: | Single macrocalcification focus |
| ‣ Architectural distortion: | None |
| ‣ Asymmetry: | None |
| ‣ Intramammary node: | None |
| ‣ Skin lesion: | None |
| ‣ Solitary dilated duct: | None |
| ‣ Associated features: | None |
Ultrasound:
 |
| Ultrasound features: 2012: Right breast, upper quadrants at 12 o’clock | |
| ‣ Mass | |
| • Location: | 2012: Right breast, upper quadrants at 12 o’clock |
| • Number: | 1 |
| • Size: | 1.0 × 0.8 cm |
| • Shape: | Oval |
| • Orientation: | Not parallel |
| • Margins: | Circumscribed, 2–3 lobulations present |
| • Echo pattern: | Hypoechoic |
| • Posterior features: | No posterior features |
| ‣ Calcifications: | None |
| ‣ Associated features: | None |
| ‣ Special cases: | None |
BI-RADS:
BI-RADS Category (2012): 3 (probably benign)BI-RADS Category (at follow-up (2017)): 2 (benign)
BI-RADS Category (at follow-up (2018)): 2 (benign)
Case summary:
| Premenopausal woman with increased risk of breast cancer because of family history of breast cancer in a first-degree relative presented for mammography screening. She attended for regular annual follow-up for 6 years. On initial assessment, diagnosed as grouped calcifications of suspicious morphology in right breast, BI-RADS 3 on imaging. At 6 year follow-up, diagnosed with involuting (partially calcified) fibroadenoma in right breast, BI-RADS 2 on imaging, and stable, typically benign calcifications in left breast, BI-RADS 2 on imaging. |
Learning points:
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