42-year-old female with a lump in her right breast

 

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Doctor's Information

Name : Mojgan
Family :Kalantari
Affiliation : Radiology Department,Mahdieh Hospital ,SBMU
Academic Degree: Assistant Professoe of Radiology
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : Hussein Soleimantabar

 

Case Section

Breast Imaging

 

Patient's Information

Gender : Female
Age : 42

 

Clinical Summary

42-year-old female with a lump in her right breast

 

 

Imaging Findings

There is a mass in lower inner quadrant of right breast with ill-defined and spiculated border. The lesion is mainly hypoechoic on grayscale ultrasound, measuring approximately 27*19mm. On color doppler study the lesion is hypovascular. Dynamic MRI study of the lesion depicts rapid contrast enhancement and early wash-out compatible with a malignant lesion.

 

Differential Diagnosis

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Final Diagnosis

Invasive ductal carcinoma (NOS) grade II/III

 

Discussion (Related Text)

Kinetic curves improve the specificity of breast MR. These curves can be evaluated qualitatively according to the curve shape and classified as a persistent pattern of enhancement, a plateau of enhancement, or washout of signal intensity. Most invasive carcinomas demonstrate rapid initial enhancement with a plateau or washout. Some malignant lesions, such as DCIS, invasive lobular carcinoma, tubular carcinoma, and mucinous carcinoma, may demonstrate slow enhancement. A curve showing progressive increase in signal intensity after the first 2 minutes is more suggestive of a benign etiology. Enhancement curves are helpful for lesions that are indeterminate or benign in morphology and may influence the decision to biopsy. Any morphologically suspicious lesion, however, requires biopsy regardless of its enhancement kinetics.

 

References

Brant, William E.; Helms, Clyde A. Fundamentals of Diagnostic Radiology, 3rd Edition

 

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