Case 15
Indication: Resistance in upper outer quadrant of the right breast.
History: No abnormalities.
Risk profile: No increased risk.
Age: 51 years.
Fig. 15.1 Ultrasound image from the area of the palpable mass.
Fig. 15.2a,b Digital mammography, CC view.
Clinical Findings
Well-defined resistance of approximately 3 mm diameter in the upper outer quadrant of the right breast. Generally lumpy parenchymal structure.
Fig. 15.3a,b Digital mammography, MLO view.
Fig. 15.4a–c Contrast-enhanced MR mammography.
Fig. 15.5a,b Signal-to-time curves.
Fig. 15.6 Contrast-enhanced MR mammography. Maximum intensity projection.
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Please characterize ultrasound, mammography, and MRI findings.
What is your preliminary diagnosis?
What are your next steps? |
This is the imaging study of a symptomatic woman. The resistance in the right upper outer quadrant had the characteristics of a harmless nodular gland. Nevertheless, this was the reason the patient presented for mammography. The risk profile was not increased.
Ultrasound
Corresponding to the location of the resistance in the right breast, there is a well-defined, lobulated mass of 2 mm diameter with markedly hyperechogenic borders. The architectural structure is distorted in this area. US BI-RADS right 5.
Mammography
The parenchyma was bilaterally symmetric and extremely dense, ACR type 4. Under these limiting conditions, mammography showed no specific findings in the area of the clinically observed mass or elsewhere. There were no visible masses, densities, calcifications, or architectural distortion (BI-RADS right 1/left 1). PGMI: CC view P; MLO view P.
MR Mammography
Corresponding to the clinical and ultrasound findings, MRI shows a hypervascularized, round, partially ill-defined mass of approx. 1 cm diameter, lateral to the right nipple. This lesion showed an intermediate signal on T2-weighted images.
MRI Artifact Category: 2
MRI Density Type: 2
Fig. 15.7 Lesion in ultrasound.
Preliminary Diagnosis
