Presentation
Diagnostic mammography. Left breast palpable mass on physical exam.
Patient Data
Diagnostic digital 2D mammography and tomosynthesis with CC and MLO views show three mass-like lesions with irregular margins in the left breast's upper part, causing mild surrounding parenchymal distortion. No internal calcification, skin thickening and nipple retraction could be noted. (BI-RADS 4)
No enlarged lymph node is identified in the imaged part of the left axillary.
Case Discussion
Ultrasound-guided core needle biopsy is performed for all three left breast BI-RADS 4 lesions.
Pathology:
Microscopic study of mammary tissue reveals malignant lesions composed of neoplastic epithelial cells that arranged in small and relatively uniform tumor cells growing singly, in Indian file, and small lobular structures, in a concentric fashion around lobules. The individual tumor cells are small and uniform, and mitotic figures are rare. The stroma is of dense fibrous type, and a lymphocytic infiltrate is present.
Diagnosis:
Left breast 1,2,3 masses, invasive lobular carcinoma, classic type.
Invasive lobular carcinoma represents 5-10% of all breast cancer, and there is a greater rate of contralateral breast cancer compared with invasive carcinoma of no special type.
Before the left mastectomy due to the multifocal multicentric invasive lobular carcinoma, the patient underwent a bilateral breast MRI, and there was no suspicious lesion in the right breast.
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