Apparent Ipsilateral Decrease in Breast Size at Mammography: A Sign of Infiltrating Lobular Carcinoma1
Jennifer A. Harvey, MD,
Robert E. Fechner, MD and
Marcia M. Moore, MD
1 From the Departments of Radiology (J.A.H.), Pathology (R.E.F.), and Surgery (M.M.M.), University of Virginia, Box 170, Charlottesville, VA 22908. Received September 10, 1998; revision requested October 22; final revision received June 9, 1999; accepted August 18. Address reprint requests to J.A.H.
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Figure 1a. Images obtained in a 59-year-old woman with diffuse thickening in the right breast. (a) Bilateral MLO mammograms from 2 years earlier and (b) current MLO mammograms show a marked apparent interval decrease in the size of the right breast (wires mark scars from previous surgical biopsies with benign findings). Architectural distortion was noted on the craniocaudal view (not shown) but is not seen in b. A 102-mm diffusely infiltrating lobular carcinoma was present. (c) Photomicrograph shows that most of the histologic specimen is occupied by tumor cells, although small islands of fat or individual fat cells (arrows) are entrapped in the tumor. (Hematoxylin-eosin stain; original magnification, x150.)
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Figure 1b. Images obtained in a 59-year-old woman with diffuse thickening in the right breast. (a) Bilateral MLO mammograms from 2 years earlier and (b) current MLO mammograms show a marked apparent interval decrease in the size of the right breast (wires mark scars from previous surgical biopsies with benign findings). Architectural distortion was noted on the craniocaudal view (not shown) but is not seen in b. A 102-mm diffusely infiltrating lobular carcinoma was present. (c) Photomicrograph shows that most of the histologic specimen is occupied by tumor cells, although small islands of fat or individual fat cells (arrows) are entrapped in the tumor. (Hematoxylin-eosin stain; original magnification, x150.)
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Figure 1c. Images obtained in a 59-year-old woman with diffuse thickening in the right breast. (a) Bilateral MLO mammograms from 2 years earlier and (b) current MLO mammograms show a marked apparent interval decrease in the size of the right breast (wires mark scars from previous surgical biopsies with benign findings). Architectural distortion was noted on the craniocaudal view (not shown) but is not seen in b. A 102-mm diffusely infiltrating lobular carcinoma was present. (c) Photomicrograph shows that most of the histologic specimen is occupied by tumor cells, although small islands of fat or individual fat cells (arrows) are entrapped in the tumor. (Hematoxylin-eosin stain; original magnification, x150.)
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Figure 2a. Left MLO mammograms obtained in a 45-year-old woman with a 70-mm diffusely infiltrating lobular carcinoma and an apparent decrease in mammographic size. Left MLO views from (a) August 1995, (b) February 1996, and (c) August 1996 show that the breast appears to be decreasing in size and increasing in density. The mammogram obtained at the time of diagnosis, c, shows only dense fibroglandular tissue with no apparent mammographic mass (BB marks the location of thickening noted at examination).
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Figure 2b. Left MLO mammograms obtained in a 45-year-old woman with a 70-mm diffusely infiltrating lobular carcinoma and an apparent decrease in mammographic size. Left MLO views from (a) August 1995, (b) February 1996, and (c) August 1996 show that the breast appears to be decreasing in size and increasing in density. The mammogram obtained at the time of diagnosis, c, shows only dense fibroglandular tissue with no apparent mammographic mass (BB marks the location of thickening noted at examination).
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Figure 2c. Left MLO mammograms obtained in a 45-year-old woman with a 70-mm diffusely infiltrating lobular carcinoma and an apparent decrease in mammographic size. Left MLO views from (a) August 1995, (b) February 1996, and (c) August 1996 show that the breast appears to be decreasing in size and increasing in density. The mammogram obtained at the time of diagnosis, c, shows only dense fibroglandular tissue with no apparent mammographic mass (BB marks the location of thickening noted at examination).
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Figure 3a. Images obtained in a 58-year-old woman with no current breast complaints and no mammographic change in size. (a) Left MLO mammogram shows a discrete mass (arrow). (b) Photomicrograph of a tissue section at low power shows a well-defined mass with a dense central fibrotic reaction (straight arrow). Tumor infiltration (curved arrow) is limited to a short distance from the margin of the mass. (Hematoxylin-eosin stain; original magnification, x30.)
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Figure 3b. Images obtained in a 58-year-old woman with no current breast complaints and no mammographic change in size. (a) Left MLO mammogram shows a discrete mass (arrow). (b) Photomicrograph of a tissue section at low power shows a well-defined mass with a dense central fibrotic reaction (straight arrow). Tumor infiltration (curved arrow) is limited to a short distance from the margin of the mass. (Hematoxylin-eosin stain; original magnification, x30.)
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Figure 4a. Images obtained in a 54-year-old woman with thickening in the left upper outer quadrant and a mammographic decrease in size. (a) Left craniocaudal mammogram shows architectural distortion (arrow) that was not apparent on the MLO view (not shown). (b) Photomicrograph of a random section obtained several centimeters from the primary tumor shows a skip area with rows of infiltrating tumor cells (straight arrows) that surround two otherwise small normal ducts (curved arrows). The fibrous tissue is indistinguishable from the fibrous stroma of normal breast. Numerous skip areas of tumor involved all four quadrants. (Hematoxylin-eosin stain; original magnification, x150.)
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Figure 4b. Images obtained in a 54-year-old woman with thickening in the left upper outer quadrant and a mammographic decrease in size. (a) Left craniocaudal mammogram shows architectural distortion (arrow) that was not apparent on the MLO view (not shown). (b) Photomicrograph of a random section obtained several centimeters from the primary tumor shows a skip area with rows of infiltrating tumor cells (straight arrows) that surround two otherwise small normal ducts (curved arrows). The fibrous tissue is indistinguishable from the fibrous stroma of normal breast. Numerous skip areas of tumor involved all four quadrants. (Hematoxylin-eosin stain; original magnification, x150.)
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Copyright © 2000 by the Radiological Society of North America.
