Читать книгу Breast Imaging - Beverly Hashimoto - Страница 27

Case 13

Case History

A 40-year-old woman presents with a palpable left breast lump.

Physical Examination

• left breast: palpable lump in left lateral breast

• right breast: normal exam

Mammogram

Mass (Fig. 13–1)

• margin: well defined

• shape: oval

• density: equal

Figure 13–1. At the 3:00 position of the left breast, there is an oval mass (arrows). The spot compression view demonstrates that the mass has well-defined margins and a lucent halo around part of the border. (A). Left MLO mammogram. (B). Left CC mammogram. (C). Left MLO spot compression mammogram.

Ultrasound

Frequency

• 10 MHz

Mass

• margin: well defined

• echogenicity: hypoechoic

• retrotumoral acoustic appearance: no shadowing

• shape: oval (Fig. 13–2)

Figure 13–2. Left radial breast sonogram: The oval mammographic density identified in Figure 13–1 corresponds to a well-defined hypoechoic solid mass.

Pathology

• Fibroadenoma

Management

• BI-RADS Assessment Category 3, probably benign; short-interval follow-up

Pearls and Pitfalls

Sonographically, if the mass has a well-defined margin, hyperechoic thin capsule, and no shadowing and is also homogeneously hypoechoic, then the chances of malignancy are very low (<5%). Since this mass represents a new palpable lump that has not been identified previously, we chose short-term follow-up to assess growth rate and stability of appearance. However, the patient chose to biopsy this lesion.

Suggested Readings

1. Cole-Beuglet C, Skoriano RZ, Kurtz AB, Goldberg BB. Fibroadenoma of the breast: sonomammographically correlated with pathology in 122 patients. AJR 1983;140:369–375.

2. Fornage BD, Lorigan JB, Andry E. Fibroadenoma of the breast: sonographic appearance. Radiology 1989;172:671–675.

3. Jackson VP, Rothschild PA, Kreipke DL, et al. The spectrum of sonographic findings of fibroadenoma of the breast. Invest Radiol 1986;21:34–40.

4. Stavros AT, Thickman D, Rapp CL, Dennis MA, Parker SH, Sisney GA. Solid breast nodules: use of sonography to distinguish between benign and malignant lesions. Radiology 1995;196:123–134.