Question 1664
{"accessible":true,"alternatives":[{"id":8282,"text":"ductal carcinoma in situ (DCIS)"},{"id":8280,"text":"fibroadenoma"},{"id":8281,"text":"invasive breast cancer "},{"id":8283,"text":"simple cyst"}],"archived":false,"correctAlternativeId":8281,"explanation":"\u003cp\u003eA new mass in a middle-aged woman must be considered malignant until proven otherwise.\u003c/p\u003e\u003cp\u003eFibroadenomas can enhance, but tend to do so less avidly than invasive breast cancer, and are usually well-defined.\u0026nbsp;\u003c/p\u003e\u003cp\u003eThis lesion is avidly enhancing and irregular – typical of invasive ductal carcinoma.\u0026nbsp;\u003c/p\u003e\u003cp\u003eDCIS can enhance at CESM, but is more likely to show non-mass enhancement (there is often associated calcification on the low energy images – absent in this case).\u0026nbsp;\u003c/p\u003e\u003cp\u003eA simple cyst has no vascularity and therefore appears as a \u003cem\u003elack of\u003c/em\u003e enhancement on the recombined images.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e","id":1664,"imageUrl":"https://prod-images-static.radiopaedia.org/images/52956454/6b6b8c28910acd73f3ac9e69d8e594_big_gallery.jpeg","imageAttribution":{"kind":"case","rID":79131},"imageAttributionCaseInfo":{"title":"Breast cancer on contrast mammogram","contributor_name":"Sarah Tennant","contributor_param":"dr-sarah-tennant","case_rid":79131,"case_param":"breast-cancer-on-contrast-mammogram"},"firstQuestionPath":"/questions/1664","nextQuestionPath":null,"relatedArticles":[{"id":12684,"title":"Ductal carcinoma in situ","link":"/articles/ductal-carcinoma-in-situ?lang=us"},{"id":9021,"title":"Fibroadenoma (breast)","link":"/articles/fibroadenoma-breast?lang=us"},{"id":29143,"title":"Invasive breast carcinoma of no special type","link":"/articles/invasive-breast-carcinoma-of-no-special-type-1?lang=us"},{"id":15406,"title":"Contrast-enhanced mammography","link":"/articles/contrast-enhanced-mammography-2?lang=us"}],"alsoUsedIn":[{"id":648,"kind":"Course","title":"Radiopaedia 2020 - Lectures Only - page 648","link":"https://radiopaedia.org/courses/radiopaedia-2020-exclusive/pages/648"},{"id":648,"kind":"Course","title":"2020 Virtual Conference Private Use - page 648","link":"https://radiopaedia.org/courses/2020-virtual-conference-private-use/pages/648"}],"stem":"\u003cp\u003eA 50 year old female presents with a new lump in the left breast and undergoes contrast mammography.\u0026nbsp; The left MLO recombined image is shown.\u0026nbsp; The low energy image showed no additional finding.\u0026nbsp;\u003c/p\u003e\u003cp\u003eWhat is the most likely diagnosis?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/1664"}],"attemptsPercentages":[{"alternativeId":"8280","percentage":22},{"alternativeId":"8282","percentage":24},{"alternativeId":"8281","percentage":49},{"alternativeId":"8283","percentage":5}],"promptToLogin":false,"questionManager":false,"articleId":"breast-cyst"}