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Figure 3b. Images obtained in a 66-year-old woman with a palpable mass in the upper quadrant of the left breast and breast erythema. The right breast was normal. (a) Mediolateral oblique mammogram of the left breast shows trabecular thickening (arrows), a spiculated mass (*) 1.5 cm in longest diameter, and diffuse pleomorphic microcalcifications suggestive of malignancy. Round axillary nodes (arrowheads) with increased density and loss of lucent fatty hilum are consistent with axillary lymphadenopathy. (b) Pleomorphic microcalcifications (arrowheads) are better seen on the close-up image (photographic enlargement). (c) Transverse US scans show that the mass (thick arrow) with irregular contour has invaded the skin (thin arrows). Findings at histopathologic examination of the surgical specimen removed at mastectomy confirmed direct dermal invasion. Histologic subtype and size: invasive ductal carcinoma, 1.7 cm in longest diameter.