MR mammography iqbal tgl 2 oktober 2015

Reporting female patient, 49 (forty nine) years old. Referred from oncology department, with
clinical information Carcinoma mamma. Asked for mammography

From history taking :

She complained of having lump in the right breast since 3 months ago. No pain or nipple discharge at
the right breast. No complain in the left breast

From physical examination : there was palpable lump, firm, mobile, size about 2 by 3 cm, no pain
on palpation, no erythema on the skin, no nipple retraction

From mammography left and right breast, CC and MLO projection :

Right :

- Right parenchymal is scattered area of fibroglandular density

- There is high density mass in the upper-outer quadrant right breast, irregular shape,
speculated margin, size about 1.5 x 2 (one point five ) cm with calcification inside it
- There is no skin thickening and papilla retraction on the right breast
- There are lymph nodes, oval shaped, positive hilum, with short-axis width about 0,5 cm in
the right axilla

Left :

- Left breast parenchymal is scattered area of fibroglandular density

- There is no mass on the left breast
- There is Punctate calcification with group distribution at the central left breast
- There is no parenchymal distortion, skin thickening and papilla retraction on the left breast
- There are lymph nodes, oval shaped, positive hilum, with short-axis width about 1 cm in the
left axilla
-

Our conclusion :

- Highly suggestive of malignancy mass in right breast (BIRADS C5)

- Non suspicious lymphadenopathy of right axilla
- Left breast benign calcification with non suspicious lymphadenopathy in the left axilla (BI-
RADS C2)

Thank you Doctor

Margin benign :

1. Circumscribe
2. Obsecured

Suspicious margin :

1. Microlobulated
2. Indistinct
3. Speculated

Kalsifikasi benign :

1. Skin calcification
2. Vascular calcification
3. Coarse calcification
4. Large rod like
5. Rim calcification
6. Dystrofic (> 1mm)
7. Milk of calcium
8. Suture calcification
9. Round calcification
10. Punctate calcification

Kalsifikasi suspicious :

1. Amorphous
2. Fine pleomorphic (< 0,5 mm )  BIRADS C4c
3. Coarse heterogenous ( 0,5-1 mm )  C4b
4. Fine linear 4c
5. Fine linear branching 4c

Distribution

1. Difuse
2. Regional  diameter > 2 cm
3. Group  diameter 2 cm, min 5 calcification
4. Linear  line, in duct
5. Segmental  duct and branches

C0 : need additional imaging  recall for additional imagin

C1 : -  routine screening  symetric, no mass, architectural distortion / suspicious calcification

C2 : Benign  routine sceering  pop corn, large rod like, vascular thickening, implants,
intramammary lymph nodes
C3 : probably benign  short interval follow up 

non palpable, circumscribed mass

Focal asymmetric which become less dense

Solitary grup of punctate calcification

C4 : 4a :  partially circumscribed, suggestive of FAM (atypical)

Palpable, solitary, complex cyst

Probable abscess

4b :  group amorphous or fine pleomorphic

Non descript solid mass with indistinct

4c :  new group of line calcification

New indistinct, irregular solitary mass

C5 : highly suggestive of malignancy 

speculated, irregular high density mass Segmental / linear arregement of fine linear

Irregular speculated mass + pleomorphic calcification