148

Case 148

Case History

A 68-year-old patient presents with left breast swelling and shortness of breath.

Physical Examination

• left breast: entire breast is hard and lumpy; diffuse skin thickening and erythema present; palpable nodes present in the left axillary and supraclavicular areas

• right breast: normal exam

• chest: decreased breath sounds bilaterally at bases

Mammogram

Mass

• margin: indistinct

• shape: irregular

• density: high density

• skin thickening

• trabecular thickening (Fig. 148–1)

Figure 148–1. The left breast shows marked, diffuse increase in density compared with the right breast. There is associated skin thickening and diffuse nodularity throughout the left breast. (A). Right MLO mammogram. (B). Left MLO mammogram.

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