4b (Breast) - Answer: 64-year-old female presents with history of breast calcification

HISTORY: 

This 64-year-old female presents with history of breast calcification. Family history of breast cancer in mother, grandmother, sister, and aunt. Therefore, heredofamilial breast cancer. Patient has known fibrous tissue with history of breast biopsy and aspiration.


(QUIZ ANSWER) MOST LIKELY BI-RADS SCORE: 

Category 4c.


Using the diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.


FINDINGS: 

Right Breast: In the lower outer quadrant in zone C of the posterior one-third of the breast sitting at approximately the 7 o'clock position is an irregular branching non mass-like area of instantaneous enhancement most compatible with invasive ductal carcinoma. Other considerations would include atypical ductal hyperplasia and lobular neoplasia. The lesion is unifocal and unicentric.

Surrounding stippled non mass-like areas of enhancement are too small to characterize and are likely unrelated. 

The area of interest is non mass-like but is approximately 2cm in diameter. 

No foci of adenopathy are noted.

Nipple, chest wall, and remaining breast parenchyma unremarkable. 

Left Breast: Normal left breast including nipple, chest wall, axillary region and parenchyma. Breast density 1/4. 


CONCLUSION: 

1. Right breast: 

a. Irregular branching-type pattern of early enhancement for which invasive ductal carcinoma or high-grade DCIS will require exclusion. 

b. BI-RADS 4C. 

2. Left breast: 

a. BI-RADS 1.


Discussion
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