Asymmetry of the right lower medial quadrant associated with superimpositions

Diagnosis

Asymmetry of the right lower medial quadrant associated with superimpositions

History

Systematic examination. No personal risk factors.
Pre-menopausal.
Two cases of breast cancer in the family, one in an aunt on the paternal side and one in a pre-menopausal first cousin.
 
The clinical examination was without particularity.

Findings

On the mammogram, the breasts were dense and heterogeneous of type III, with a relatively stable aspect in comparison with the previous examinations.
On the frontal image, we can see on the internal topography a pseudo-nodular increase in density that is not completely effaced on the compression images. This increase in density was less clearly visible at the previous examination.
In addition, no site of pathological micro-calcification. Presence of rare bilateral micro- and macro-calcifications.
 
An additional examination carried out with ultrasound found, as during the previous examinations, multiple round formations, some of which suggested cysts with thick content and others of the dystrophic or fibroadenomatous type. There are several at the level of the left upper medial quadrant.

Key points

Here, there was asymmetry with a density that was visible only from the front of the left breast, facing the medial quadrants and that was not really effaced under compression, with no corresponding ultrasound anomaly.
With tomosynthesis, this zone was no different from the rest of the adjacent gland and it indeed seemed to be an image composed by superimposition.
An MRI was carried out, revealing no suspicious enhancement.
For greater security, the examination was classified ACR 3 and there was no modification at 1 year.