Presentation
Generally lumpy breasts. Screening mammogram.
Patient Data
Lobulated mass which is partially circumscribed but with indistinct posterior border is present in the inferior inner quadrant of the left breast. There are also several smaller low density circumscribed masses seen bilaterally, one of which on the left contains coarse "popcorn" calcifications highly suggestive of an involuting fibroadenoma.
There is a background of heterogeneously dense fibroglandular tissue with diffuse benign appearing calcifications.
Comparison with the previous mammogram demonstrates interval increase in size and density of the medial breast lesion. Other findings have been stable.
At ultrasound, this is a circumscribed hypoechoic mass which has multiple lobulations with some angular margins.
Case Discussion
This is a suspicious lesion on imaging (BIRADS IV) based on: interval growth, indistinct margin and density on mammogram, multiple lobulations and angular margins on ultrasound.
Final diagnosis: benign phyllodes tumor.
Although the final diagnosis is of a benign lesion with favorable prognosis, histologic diagnosis is warranted based on imaging appearance.