PMC5777554_01
(a) FFDM left breast (craniocaudal [CC] projection) shows a high-density spiculated mass in the medial-posterior fatty part of the breast. (b) DBT in the same projection confirms the FFDM findings. The spiculations are more clearly presented at DBT, but no additional information is given. Histopathology of the surgical specimen of case 1 (hematoxylin and eosin stain; 40x [left panel] and 200x [right panel] magnification). (c) The irregular margins of the lesion with infiltrative processes in the fat tissue, which mimic an infiltrating carcinoma. (d) On higher magnification, the long sweeping bundles of bland, cytologically benign spindle cells can be seen. Normal breast glands may be trapped within the lesion. Immunostains were negative for cytokeratins and p63, thereby excluding a carcinoma diagnosis.
10.1177_2058460117752034-fig1.jpg
PMC5777554_01_10.1177_2058460117752034-fig1.jpg
fig1-2058460117752034
The desmoplastic reaction (spiculations) was more obvious at DBT than at FFDM (Fig. 1a and b). Histopathology showed fibromatosis of desmoid tumor type with infiltration of the pectoral muscle (Fig. 1c and d).
PMC5777554_02
(a) Synthetic 2D mammogram, Mediolateral oblique view right breast showing scattered fibroglandular tissue but no sign of malignancy. (b) DBT shows a small non-specific mass. (c) Synthetic 2D CC view demonstrates a suspicious area but the finding is inconclusive. (d) DBT in CC projection clearly demonstrates a small spiculated mass. (e) Ultrasound showing irregular hypoechoic mass with posterior shadowing, typical of carcinoma.
10.1177_2058460117752034-fig2.jpg
PMC5777554_02_10.1177_2058460117752034-fig2.jpg
fig2-2058460117752034
A 65-year-old woman was recalled from mammography screening because of a distortion in the upper medial portion of the right breast not seen at 2D (reconstructed synthetic 2D images) (Fig. 2a and c) but detected at tomosynthesis (Fig. 2b and d). Ultrasound demonstrated a 6-mm irregular hypoechoic mass at 2 o'clock with extensive posterior shadowing highly suspicious of malignancy (Fig. 2e).