Fig. 47.1 Sonography.

Fig. 47.2 Sonography.

Clinical Findings

Normal.

Fig. 47.3a,b Digital mammography, CC view.

Fig. 47.4a,b Digital mammography, MLO view.

Fig. 47.5a-c Contrast-enhanced MRI of the breasts.

Fig. 47.7a-c Magnification view of the enhancing lesion and signal-to-time curve.

Ultrasound

There was a hypoechoic lesion with ill-defined borders in the right breast lateral to the areola, with moderate acoustic shadowing behind the lesion. However, ultrasound did not show definitive signs of malignancy. US BI-RADS right lateral 4.

Mammography

Mammograms showed inhomogeneous dense parenchyma, ACR type 3. Consistent with the ultrasound finding, in the CC view there was an impression of slight asymmetry in the lateral glandular tissue, with possible hyperdensity within the parenchyma. However, there were no clear signs of malignancy. Otherwise, no unusual findings. There were no architectural distortions and no calcifications were visible (BI-RADS right 3/left 1). PGMI: CC view P; MLO view G (skin fold, inframammary fold).

MR Mammography

MRI depicted a single oval hypervascularized lesion measuring7 mm in the lateral part of the right breast, clearly corresponding to the finding in ultrasound. This lesion had a high signal in T2-weighted imaging. MR imaging showed no other abnormalities.

MRI Artifact Category: 1

MRI Density Type: 1

Preliminary Diagnosis

Fibroadenoma.

Differential Diagnosis

Adenoma, papilloma, carcinoma.

Procedure

Histological analysis of the lesion in the right breast after US-guided percutaneous core biopsy.

Histology of the right breast (5 specimens)

Fat necrosis.

Fig. 47.8a,b Macrohistology of a representative specimen showing fat necrosis.