Focal breast lesions with benign appearances. Review of eight breast cancers with initial features of intramammary lymph node

Abstract

Although uncommon, a lesion with the radiographic features of an intramammary lymph node may hide an early breast cancer. No significant relationship exists between histological type and the presence of such features.

Characterisation of indeterminate focal breast lesions on grey-scale ultrasound: role of ultrasound elastography

“…However, three carcinomas classifi ed as BI-RADS 3 (one mucinous, one tubular and one invasive ductal) had a benign US elastography score, at least in part as a result of histological features such as high mucin content, or a size >2 cm that can lead to lesion heterogeneity due the presence of necrotic-colliquative areas, as demonstrated by Giuseppetti et al [6]. In this regard, it would seem appropriate to periodically follow-up BI-RADS 3 lesions not subjected to biopsy in order to assess their stability over time and thus lower the risk of missing the opportunity of early diagnosis of a possible malignancy [19]. In contrast, the PPV of US elastography in BI-RADS 4 focal breast lesions -64.7% in our experience -is not suffi ciently high to the need for biopsy on the basis of the US elastography score alone, as suggested by a previous report on nonpalpable breast lesions [12].…”

“…tempo e, quindi, di ridurre la possibilità di non diagnosticare tempestivamente una eventuale lesione maligna[19]. Di contro, il VPP riportato dall'elastosonografi a nell'analisi delle lesioni focali mammarie BI-RADS 4, pari nella nostra esperienza al 64,7%, non risulta abbastanza soddisfacente da consentire di escludere il ricorso alla biopsia sulla scorta del solo punteggio elastosonografi co, in accordo con quanto suggerito da un precedente studio condotto su lesioni mammarie non palpabili[12].…”