EURORAD ESR

Case 14463

Male breast cancer: a rare case of synchronous bilateral invasive ductal carcinoma.

Author(s)
Mavromati Areti, Ege Jon, Drabløs Ole, Nes Harald, Radiology Department, Igor Plotnikov Pathology Department, General Public Hospital of Haugesund, Norway.

General Public Hospital of Haugesund, Norway
 
Patient
male, 59 year(s)
 
 
  • Figure 1
    Mammography of the right breast, MLO view

    Mediolateral oblique view of the right breast shows a subareolar eccentric irregular mass with spiculated margins.

     
    Area of Interest: Breast; Imaging Technique: Mammography; Procedure: Imaging sequences; Special Focus: Neoplasia;
     
     
  • Figure 2
    Mammography of the right breast, CC view
     

    Craniocaudal projection: the suspicious mass is in the retroareolar region

     
    Area of Interest: Breast; Imaging Technique: Mammography; Procedure: Imaging sequences; Special Focus: Neoplasia;

    CC projection, zoom in image: the spiculated margins of the mass are clearly seen.

     
    Area of Interest: Breast; Imaging Technique: Mammography; Procedure: Imaging sequences; Special Focus: Neoplasia;
     
     
  • Figure 3
    Mammography of the left breast, MLO view

    An eccentric irregular opacity is depicted in the subareolar area

     
    Area of Interest: Breast; Imaging Technique: Mammography; Procedure: Imaging sequences; Special Focus: Neoplasia;
     
     
  • Figure 4
    Mammography of the left breast, CC view
     

    CC view: a suspicious nodule with irregular margins is better seen on this projection

     
    Area of Interest: Breast; Imaging Technique: Mammography; Procedure: Imaging sequences; Special Focus: Neoplasia;

    CC view, zoom in image: the mass is approx. 7mm in diameter and is located laterally to the areola

     
    Area of Interest: Breast; Imaging Technique: Mammography; Procedure: Imaging sequences; Special Focus: Neoplasia;
     
     
  • Figure 5
    Ultrasound of the right breast
     

    A mass with angulated margins corresponds to the clinically palpable lump

     
    Area of Interest: Breast; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    The size of the mass is 1,1 x 1,0cm

     
    Area of Interest: Breast; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    An ultrasound guided core needle biopsy was performed

     
    Area of Interest: Breast; Imaging Technique: Ultrasound; Procedure: Biopsy; Special Focus: Neoplasia;
     
     
  • Figure 6
    Ultrasound of the left breast
     

    A 1,0cm irregular mass is seen eccentric to the nipple-areolar complex

     
    Area of Interest: Breast; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    A core needle biopsy was performed

     
    Area of Interest: Breast; Imaging Technique: Ultrasound; Procedure: Biopsy; Special Focus: Neoplasia;
     
     
  • Figure 7
    Histopathology and Immunohistochemistry
     

    LEFT BREAST(IDC grad 1) Magnification x 4: Breast tissue with malignant infiltrating tumor (up is the malignant tumor, down is fibrous breast tissue and some dilated ductuli

     
    Area of Interest: Breast; Imaging Technique: Image manipulation / Reconstruction; Procedure: Biopsy; Special Focus: Neoplasia;

    LEFT BREAST P120: an immunohistochemistry marker that helps to differentiate between ductal and lobular carcinoma: Ductal carcinoma shows membranous reaction, lobular carcinoma cytoplasmic reaction (in our case was...

     
    Area of Interest: Breast; Imaging Technique: Image manipulation / Reconstruction; Procedure: Biopsy; Special Focus: Neoplasia;

    RIGHT BREAST (IDC grad 1) estrogen receptor: 3+ intranuclear in 100% of the cells (the same outcome to both breasts)

     
    Area of Interest: Breast; Imaging Technique: Image manipulation / Reconstruction; Procedure: Biopsy; Special Focus: Neoplasia;

    RIGHT BREAST Progesterone receptor: 3+ intranuclear in 95% of the cells (3+ intranuclear in 80% of the cells to the left breast)

     
    Area of Interest: Breast; Imaging Technique: Image manipulation / Reconstruction; Procedure: Biopsy; Special Focus: Neoplasia;
     
     
  • Figure 8
    Sentinel lymphnode biopsy from the right axilla
     

    1 out of 3 lymphnodes with metastatic tumor was found (1/3, 2,0mm with no extranodal growth - pN1a). (lymphocytes as dark small cells on the right - metastatic carcinoma on the left).

     
    Area of Interest: Lymph nodes; Imaging Technique: Image manipulation / Reconstruction; Procedure: Biopsy; Special Focus: Metastases;

    CKAE1-AE3 (a special marker): Cytokeratin verified that there is metastasis (with brown colour), this type of antibody reacts with epithelial cells but does not react with lipid and lymphoid tissue

     
    Area of Interest: Lymph nodes; Imaging Technique: Image manipulation / Reconstruction; Procedure: Biopsy; Special Focus: Metastases;
     
     
Mediolateral oblique view of the right breast shows a subareolar eccentric irregular mass with spiculated margins.
 
Craniocaudal projection: the suspicious mass is in the retroareolar region
 
CC projection, zoom in image: the spiculated margins of the mass are clearly seen.
 
An eccentric irregular opacity is depicted in the subareolar area
 
CC view: a suspicious nodule with irregular margins is better seen on this projection
 
CC view, zoom in image: the mass is approx. 7mm in diameter and is located laterally to the areola
 
A mass with angulated margins corresponds to the clinically palpable lump
 
The size of the mass is 1,1 x 1,0cm
 
An ultrasound guided core needle biopsy was performed
 
A 1,0cm irregular mass is seen eccentric to the nipple-areolar complex
 
A core needle biopsy was performed
 
LEFT BREAST(IDC grad 1) Magnification x 4: Breast tissue with malignant infiltrating tumor (up is the malignant tumor, down is fibrous breast tissue and some dilated ductuli
 
LEFT BREAST P120: an immunohistochemistry marker that helps to differentiate between ductal and lobular carcinoma: Ductal carcinoma shows membranous reaction, lobular carcinoma cytoplasmic reaction (in our case was membranous in both breasts).
 
RIGHT BREAST (IDC grad 1) estrogen receptor: 3+ intranuclear in 100% of the cells (the same outcome to both breasts)
 
RIGHT BREAST Progesterone receptor: 3+ intranuclear in 95% of the cells (3+ intranuclear in 80% of the cells to the left breast)
 
1 out of 3 lymphnodes with metastatic tumor was found (1/3, 2,0mm with no extranodal growth - pN1a). (lymphocytes as dark small cells on the right - metastatic carcinoma on the left).
 
CKAE1-AE3 (a special marker): Cytokeratin verified that there is metastasis (with brown colour), this type of antibody reacts with epithelial cells but does not react with lipid and lymphoid tissue
 
 
 
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