Fig. 39.1 Ultrasound.

Clinical Findings

Painful resistance 1 cm in diameter behind the areola of the left breast. Bilateral gynecomastia.

Fig. 39.2a,b Digital mammography, CC view.

Fig. 39.3a,b Digital mammography, MLO view.

Fig. 39.4a–c Contrast-enhanced MR mammography.

Fig. 39.5a–c Contrast-enhanced MR mammography.

Fig. 39.6 Contrast-enhanced MR mammography. Maximum intensity projection.

Fig. 39.7a,b Signal-to-time curves.

Ultrasound

In the area of the resistance in the left breast, ultrasound showed ahypoechoic, lobulated mass (diameter 1 cm) with indeterminate distal echo pattern. US BI-RADS left 4.

Mammography

Mammograms demonstrated asymmetry of the parenchyma (left> right). There were no densities, architectural distortion, or microcalcifications. No circumscribed lesions. BI-RADS right 2/left 3.PGMI is not defined for imaging of men.

MR Mammography

MRI showed asymmetric parenchyma with partially ill-defined periphery. There was a notable unilateral enhancement of the left side after contrast administration, with a nonspecific signal curve. There were no unusual findings contralaterally.

MRI Artifact Category: 1

MRI Density Type: 1

Preliminary Diagnosis

Right: Gynecomastia.

Left: Gynecomastia (asymmetrically to the other breast), mastitis, diffuse invasive carcinoma.

Procedure

US-guided core biopsy.

Fig. 39.8 a, b Pre-fire and post-fire documentation of US-guided core biopsy.