A case of breast lump - mammography, ultrasound, mri and pathological correlation

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A 60 year old female patient came with complaints of lump in the left breast gradually increasing in size for last 6 months. There was no history of any nipple discharge, pain, trauma, nipple retraction or no other significant past surgical history. On palpation a hard lump was felt in the left breast in lower inner quadrant.
Both breast shows scattered fibroglandular tissue. An irregular high density mass with spiculated margins is noted in lower inner quadrant of left breast. No evidence of any skin thickening, nipple retraction or calcification is noted, suggests possibility of birads 4c lesion(HPE Correlation). A well circumscribed ovoid high density lesion noted in the upper outer quadrant of right breast, suggest possibility of birads 3 lesion(Rec: USG correlation/ follow up). Another similar density ovoid lesion with obscured margin noted medial to the above mentioned lesion in right breast, suggest possibility of birads 3 lesion(HPE Correlation). Bilateral axillary lymph nodes are noted.

This was mammogram of the same patient repeated in a different centre within a short interval shows same lesions with same morphology.

USG of the left breast lesion shows an irregular non parallel hypoechoic mass with spiculated margins, showing posterior acoustic shadowing and taking vascularity on colour doppler study is noted in 7 o clock position — birads 4 c lesion. The strain elastography shows a predominantly hard mass.  

USG image of the same lesion 



A hypoechoic oval well cicumsribed lesion with parallel orientation not taking vascularity on colour Doppler study is noted in 10 o clock position of right breast, suggest possibility of birads 3 lesion. On HPE this lesion was fibroepithelial lesion with usual Ductal hyperplasia.
An oval hypoechoic well circumscribed lesion with parallel orientation without any calcification, not taking vascularity on colour dopppler study is noted in 9 o clock position in right breast, suggest possibility of birads



T1 contrast enhanced image shows an irregular lesion with spiculated margins showing heterogenous enhacement showing type 3 kinetic curve.

HPE report 






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