2b (Breast) - Answer: 59-year-old male presents with history of poorly-differentiated invasive carcinoma

HISTORY: 

This 59-year-old male presents with history of poorly-differentiated invasive carcinoma.


(QUIZ ANSWER) BI-RADS SCORE: 

Category 6.


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: Predominantly fatty breast tissue present. An approximately 2.6cm x 2.4cm x 2.4cm hypervascular enhancing mass is present at the sub-areolar region of the right breast, extending superiorly towards the 12 o'clock position, consistent with biopsy-proven carcinoma. The overlying right nipple appears slightly thickened. 

The right chest wall is unremarkable. Multiple predominantly small lymph nodes with fatty hila are present in the right axilla. However, there is also an approximately 1.7cm x 1.2cm x 1.6cm right axillary lymph node without a fatty hilus, raising the suspicion for a pathologically-enlarged lymph node. Consider biopsy of this finding. 

Left Breast: Predominantly fatty left breast tissue present. No evidence of hypervascular invasive or infiltrating mass present in the left breast. The left nipple, areola and skin surface are unremarkable. Minimal gynecomastia present. 

The left chest wall is unremarkable. No evidence of left axillary lymphadenopathy present. 


IMPRESSION:

Right Breast: Sub-areolar mass extending slightly superiorly consistent with biopsy-proven invasive carcinoma. 

Mildly enlarged right axillary lymph node concerning for pathologic enlargement / metastasis. Consider biopsy. 

BI-RADS category 6 for the right breast

Left Breast: Predominantly fatty left breast tissue. Small amount of fibroglandular tissues. 

No evidence of hypervascular invasive or infiltrating mass present in the left breast. 

BI-RADS category 1 for the left breast