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Atlas of breast cancer early detection

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Case number:057
Age:70
Clinical presentation:Postmenopausal woman with average risk of developing breast cancer presented with lump of duration 3–4 months in the left breast. Subsequently she also developed discharge from the left nipple. Examination revealed a 1 × 2 cm lump in the inner lower quadrant of the left breast. Nipple discharge was serous in nature.


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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