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SBR grade 2 infiltrating ductal carcinoma

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History

Past family history of breast cancer in a first cousin.
No hormone replacement treatment.


Findings

A slightly retractile zone in the right upper lateral quadrant, which was not revealed with tomosynthesis, with a few dispersed, stable micro-calcifications.
At the level of the upper medial quadrant of the left breast, there was a well-defined rounded nodule, visible to about 75% of its perimeter with tomosynthesis, measuring 7 mm in diameter.
A second nodule in the lower lateral quadrant, partially calcified in “popcorn” form and stable, suggesting a fibroadenoma.
Ultrasound found it difficult to identify a 7 mm nodule in the left upper medial quadrant, as it was isoechoic in relation to the fatty tissue, and almost with posterior reinforcement.
In the lower lateral quadrant, a very adjacent nodule with irregular edges that seemed to correspond to the second mammogram image.
Given the atypical ultrasonic nature of the two nodules, an MRI was carried out, revealing:
- a nodule in the upper medial quadrant of early, fast and intense enhancement, generally regular
- a highly hypoT2 nodule in the lower lateral quadrant, not enhanced, suggesting an old fibroadenoma.
Biopsy under ultrasound of the nodule in the upper medial quadrant: SBR grade 2 infiltrating ductal carcinoma.


Diagnosis

SBR grade 2 infiltrating ductal carcinoma


Key points

Here, the tomosynthesis was falsely reassuring because of the regular aspect of the outline of the mass. It is important to search for the aspect of the edges: if the contour is partially masked, you should be suspicious and suspect a malignant lesion.



SBR grade 2 infiltrating ductal carcinoma 1-RCC 2008

1-RCC 2008

SBR grade 2 infiltrating ductal carcinoma 2-LCC 2008

2-LCC 2008

SBR grade 2 infiltrating ductal carcinoma 3-RMLO

3-RMLO

SBR grade 2 infiltrating ductal carcinoma 4-LMLO

4-LMLO

SBR grade 2 infiltrating ductal carcinoma 5-RML

5-RML

SBR grade 2 infiltrating ductal carcinoma 6-LML

6-LML

SBR grade 2 infiltrating ductal carcinoma 7-LCC 2005

7-LCC 2005

SBR grade 2 infiltrating ductal carcinoma US1

US1

SBR grade 2 infiltrating ductal carcinoma US2

US2

SBR grade 2 infiltrating ductal carcinoma RML Acquisition Tomo

RML Acquisition Tomo

SBR grade 2 infiltrating ductal carcinoma RML Tomosynthèse

RML Tomosynthèse

SBR grade 2 infiltrating ductal carcinoma LCC Acquisition Tomo

LCC Acquisition Tomo

SBR grade 2 infiltrating ductal carcinoma LCC Tomosynthèse

LCC Tomosynthèse

SBR grade 2 infiltrating ductal carcinoma T2

T2

SBR grade 2 infiltrating ductal carcinoma T1

T1

SBR grade 2 infiltrating ductal carcinoma Dynamique 1 min

Dynamique 1 min

SBR grade 2 infiltrating ductal carcinoma Soustraction 1 min

Soustraction 1 min

SBR grade 2 infiltrating ductal carcinoma Dynamique 2 min

Dynamique 2 min

SBR grade 2 infiltrating ductal carcinoma Soustraction 2 min

Soustraction 2 min

SBR grade 2 infiltrating ductal carcinoma Dynamique 3 min

Dynamique 3 min

SBR grade 2 infiltrating ductal carcinoma Soustraction 3 min

Soustraction 3 min

SBR grade 2 infiltrating ductal carcinoma Dynamique 4 min

Dynamique 4 min

SBR grade 2 infiltrating ductal carcinoma Soustraction 4 min

Soustraction 4 min

SBR grade 2 infiltrating ductal carcinoma Dynamique 5 min

Dynamique 5 min

SBR grade 2 infiltrating ductal carcinoma Soustraction 5 min

Soustraction 5 min

SBR grade 2 infiltrating ductal carcinoma T1 Gado

T1 Gado

SBR grade 2 infiltrating ductal carcinoma Sagittal T1 Gado FatSat

Sagittal T1 Gado FatSat

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