Findings
Mammography Right: upper central high density irregular shaped mass with spiculated margin. Nipple retracted. Left: upper central high density mass with spiculated margin. Nipple retracted. Ultrasound: findings described with images
Answer
Impression: Bilateral BIRADS-5 mass. Bilateral primary breast carcinoma Next steps: - Bilateral breast mass core biopsy (confirmed IDC) - Referral to ‘high risk breast clinic’ as bilateral breast cancer
Discussion
Bilateral breast cancer: Bilateral synchronous breast cancer accounts for 0.2–2% of all breast cancers the risk of having breast cancer is substantially increased with a first–degree relative with bilateral breast cancer worse overall survival compared to unilateral tumours lower disease free survival and high rates of distant metastasis Synchronous breast cancer has a poorer prognosis than metachronous or unilateral breast cancer Please remember: Always perform ‘Bilateral mammography’ as the asymptomatic breast may have an impalpable abnormality. We are essentially screening the asymptomatic breast. Assess each breast lesion robustly when there are multiple abnormalities. THANK YOU FOR YOUR TIME!
Reference
Dalal AK, Gupta A, Singal R, Dalal U, Attri AK, Jain P, Sharma A, Gupta S. Bilateral breast carcinoma- a rare case report. J Med Life. 2011 Jan-Mar;4(1):94-6. Epub 2011 Feb 25. PMID: 21505580; PMCID: PMC3056428.
