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Atlas of breast cancer early detection

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Case number:054
Age:62
Clinical presentation:Postmenopausal woman with average risk of developing breast cancer presented with right nipple retraction of duration 4 months. She had also noted a lump in the right breast a month before presentation. Examination revealed a hard lump, 6 cm in diameter, fixed to the rest of the breast tissue but not to the underlying muscles. Axilla was unremarkable.


Mammography:





Mammography assessment:

Mammography features:
Breast composition:
 ‣ Location of the lesion:
   • Laterality:
   • Quadrant:
   • O'clock:  01:  02:  03:  04:  05:  06:
 07:  08:  09:  10:  11:  12:
 Central zone:
   • Zone:
 ‣ Mass:
   • Number:
   • Size:
   • Shape:
   • Margins:
   • Density:
 ‣ Calcifications:
   • Typically benign:
      ⁃ Skin:
      ⁃ Vascular:
      ⁃ Coarse or “popcorn-like”:
      ⁃ Large rod-like:
      ⁃ Round:
      ⁃ Rim:
      ⁃ Dystrophic:
      ⁃ Milk of calcium:
      ⁃ Suture:
   • Suspicious:
      ⁃ Amorphous:
      ⁃ Coarse heterogeneous:
      ⁃ Fine pleomorphic:
      ⁃ Fine linear or fine-linear branching:
   • Distribution:
      ⁃ Diffuse or scattered:
      ⁃ Regional:
      ⁃ Grouped or clustered:
      ⁃ Linear:
      ⁃ Segmental:
 ‣ Architectural distortion:
 ‣ Asymmetry:
 ‣ Intramammary node:
 ‣ Skin lesion:
 ‣ Solitary dilated duct:
 ‣ Associated features:
   • Skin retraction:
   • Post-operative skin retraction:
   • Skin thickening:
   • Nipple retraction:
   • Trabecular thickening:
   • Architectural distortion:
   • Calcifications:
   • Axillary lymphadenopathy:



Ultrasound:




Ultrasound assessment:

 ‣ Location of the lesion:
   • Laterality:
   • Quadrant:
   • O'clock:  01:  02:  03:  04:  05:  06:
 07:  08:  09:  10:  11:  12:
 ‣ Mass:
   • Number:
   • Size:
   • Shape:
   • Orientation:
 ‣ Margins:
   • Circumscribed:
   • Indistinct:
   • Angular:
   • Microlobulated:
   • Spiculated:
   • None:
 ‣ Echo pattern:
 ‣ Posterior features:
 ‣ Calcifications:
 ‣ Associated features:
   • Architectural distortion:
   • Duct changes:
   • Skin changes:
      ⁃ Skin thickening:
      ⁃ Skin retraction:
   • Oedema:
   • Vascularity:
      ⁃ Internal vascularity:
      ⁃ Vessels in rim:
 ‣ Special case:



Case summary:



BI-RADS:


Further assessment advised:




        
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