Presentation
Palpable abnormality in the left breast.
Patient Data
Large area of parenchymal distortion with a small number of concerning microcalcifications. Note that the center of the lesion has a relatively low density.
This is the ultrasound images of the lesion above. The microcalcifications are visible on ultrasound. The lesion is relatively speaking noted to have a low echogenicity center, i.e. there is no central mass lesion.
Case Discussion
Sclerosing adenosis is difficult to distinguish from invasive ductal carcinoma and biopsy is mandatory. However, if you see enough of these lesions and compare the images carefully with mammographic and ultrasound images, you will begin to notice the fact that the lesion is relatively low density in the center. There is a huge surrounding spiculated response but in relation to that there is actually very little happening in the center.
The diagnosis is still made with biopsy. But you can get a very good indication of the diagnosis if you look at these lesions carefully enough.
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