Sample Case: Five consecutive years of right breast screening mammograms are displayed below.
Findings: There is a developing asymmetry in the upper outer right breast. Notice the gradual increase in density in the upper outer right breast. It is difficult to appreciate an abnormality on any given year, however comparison with multiple prior studies reveals a definite change.
Diagnostic evaluation including an ultrasound reveals an irregular, spiculated hypoechoic mass. Breast MRI shows corresponding regional nonmass enhancement in the upper outer quadrant of the right breast.
Diagnosis: Invasive lobular carcinoma presenting as a developing asymmetry
Teaching Points: Notice the gradual increase in density in the upper outer right breast. It is difficult to appreciate an abnormality on any given year, however comparison with multiple prior studies reveals a definite change.
ILC’s grow in a sheet-like fashion, insinuating through the breast parenchyma. They often will present as a gradual developing asymmetry.
