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Atlas of breast cancer early detection

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Case number:021
Age:48
Clinical presentation:Premenopausal woman presented with right nipple inversion that she had had for many years. Patient had not breastfed her child from the right breast. She had an increased risk of developing breast cancer and a family history of ovarian cancer. Examination revealed nodularity in the outer quadrant of the right breast.



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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