49 y/o, Palpable Breast Mass

49-year-old female presented with palpable right breast retroareolar mass.

FIgure 1. Bilateral digital mammogram of right breast in mediolateral oblique projection.

Figure 2. Bilateral digital mammogram of left breast in mediolateral oblique projection.

Figure 3. Right breast in craniocaudal projection showing multiple ill-defined speculated masses (arrows).

Figure 4. Left breast in craniocaudal projection.

Figure 5. Enlarged irregular left axillary lymph nodes.

Figure 6. Enlarged irregular left axillary lymph nodes.

Figure 7. Ultrasound images show multiple speculated hypoechoic solid masses in many quadrants of both breasts with posterior acoustic shadows.

Figure 8. Enlarged right intramammary lymph node in the right lower inner quadrant with lost fatty hilum denting nodal malignant infiltration (arrowhead)

Bilateral digital mammograms of right (Figure 1) and left (Figure 2) breasts in mediolateral oblique projection and of right (Figure 3) and left (Figure 4) breasts in craniocaudal projection, showing multiple ill-defined speculated masses (arrows) seen in both breasts in the right side accompanied by micro-calcified foci inside and well-defined oval-shaped small mass in the right lower inner quadrant seen on the right breast (arrowhead).

Multiple enlarged left axillary lymph nodes showing loss of the fatty hilum increased short to long axis ratio.

Bilateral synchronous breast cancer is an uncommon finding in women presenting with multiple breast lumps.

Controversies also exist about the origin of second cancer (metastatic spread or independent primary) and its prognostic significance.

Several reports showed that the prognosis in bilateral breast cancer was worse than that of unilateral breast cancer.