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Atlas of breast cancer early detection

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Case number:094
Age:70
Clinical presentation:Woman aged 70 years with left breast carcinoma who underwent left MRM in 1994. She presented in 2015 with right breast serous nipple discharge. The nipple discharge is occasional, serous for 1 year, with one episode of blood-stained discharge 1 day ago.



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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