Fig. 90.1 Ultrasound.

Clinical Findings

No abnormal findings. Bilateral retracted nipples since puberty.

Fig. 90.2a,b Digital mammography, MLO view.

Fig. 90.3a,b Digital mammography, CC view.

This is the imaging study of an asymptomatic woman.

Ultrasound

Ultrasound showed a well-defined lesion measuring 9 mm in the center of the right breast, with increased distal acoustic signal. US BI-RADS right 3/left 1.

Mammography

Fibroglandular parenchyma, ACR type 2. Compared to the mammograms from 2.5 years previously, a well-defined, oval, isodense lesion had increased from 0.4 cm to 1 cm in diameter. No architectural distortion. BI-RADS right 3/left 1. PGMI: CC view P; MLO view G (inframammary fold incorrectly positioned).

Procedure

A lesion increasing in size is grounds for further investigation in a 68-year-old patient, even when morphological appearance is benign. For this reason, US-guided core biopsy was performed here.

Histology

The initial diagnosis was tubular adenoma. However, after immunohistochemical work-up a diagnosis of intraductal papilloma was reached.

Further procedure

Because of the risk of malignant transformation associated with intraductal papillomas, resection of the benign lesion was recommended.