Invasive Mammary Carcinoma

CLINICAL HISTORY

A 46-year-old patient presents for routine screening mammography. Family history of breast cancer consists of a maternal aunt and grandmother.

FINDINGS

Digital mammography reveals an irregular 2.2cm mass in the left breast, approximately 10cm from the nipple (Figure 1a-b). The mass persists on the magnification view (Figure 1c).

(Figure 1a)

(Figure 1b)

(Figure 1c)

On physical exam, no discrete mass is palpated. Ultrasound demonstrates an irregular hypoechoic mass within the left 3:30 area measuring up to 1.4cm (Figure 2).

(Figure 2)

MRI imaging performed for extent of disease demonstrates the known carcinoma measuring 2.0 x 2.2cm in the left breast (Figure 3a-b).

(Figure 3a)

(Figure 3b) 

DIAGNOSIS

Vacuum assisted stereotactic needle core biopsy of the left breast 3:30 mass reveals invasive mammary carcinoma.

DISCUSSION

This case demonstrates the benefit of screening mammography in a premenopausal woman. This was a large lesion that was not palpable and was not found by the patient or her physician. This was identified on the screening mammogram which initiated additional evaluation with magnification views, ultrasound, stereotactic biopsy, and subsequent breast MRI. 

Stamatia Destounis, MD, is managing partner and a radiologist at Elizabeth Wende Breast Care in Rochester, NY.