Presentation
Right breast lump and pain for few months.
Patient Data
An ill-defined nodular lesion measuring approximately 1.4 x 1.5 cm is seen in the right retro-areolar region. Another soft tissue density nodule measuring 5 x 7 mm (MLO view) is noted adjacent to this lesion. No microcalcification clusters are seen associated with these lesions. Mild thickening of the central right breast skin and nipple retraction is also noted. No significant axillary lymphadenopathy is seen. Left breast is normal.
An irregular/ill-defined hypoechoic lesion measuring 1.1 x 1.4 cm is is seen at 9 0'clock position in peri areolar region. Another relatively well-defined hypoechoic nodule measuring 4 x 4 mm is noted adjacent to the aforementioned lesion. A suspicious lymph node with mild cortical thickening measuring 10 mm in short axis, is seen in the right axilla.
An irregular lesion measuring 1.4 x 1.7 cm is noted in the right breast. A prominent lymph node measuring 7 mm in short axis is noted in the right axilla. A few small subcentimeter partially calcified mediastinal lymph nodes are noted. No evidence of pulmonary or osseous metastasis. Mild scoliosis, osteopenia and degenerative changes are seen in the dorsal spine.
Histopathology reports of the trucut biopsy of the right breast mass and mastectomy specimen.
Case Discussion
Highly suspicious right breast mass lesion on the mammogram (BI-RADS 5) and normal left breast mammogram (BI-RADS 1). Ultrasound and CT scan features of the right breast lesion are also highly suspicious for malignancy.
Two lesions lying adjacent to each other were noted on the mammogram and breast ultrasound; however, only one lesion was seen on the CT chest as well as in the mastectomy specimen.
Metastatic workup was negative and the patient was referred to the medical oncologist for chemotherapy after the mastectomy.
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