PMC6180830_01
Histopathological specimen from left mastectomy showing moderately pleomorphic cells with large vesicular nuclei and prominent nucleoli (arrows) consistent with invasive ductal carcinoma (haematoxylin and eosin x 400).
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f1
An immediate ultrasound-guided core needle biopsy (CNB) of the suspicious area revealed malignant features (Figure 1).
PMC6180830_02
An orthogonal sonomammographic scan of the right breast at first presentation showing a poorly circumscribed, taller than wide, hypoechoic mass located at the 12 o'clock position.
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f2
A final BI-RADS category of 4 (suspicious for malignancy) was assigned to the study (Figure 2).
Histopathological specimen of ultrasound-guided core biopsy of the right breast mass showing invasive nests and cords of moderately pleomorphic epithelial cells with hyperchromatic nuclei and eosinophilic cytoplasm with an area of comedonecrosis (arrow) consistent with invasive ductal carcinoma (haematoxylin and eosin x 100).
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She subsequently had an ultrasound-guided CNB of the right breast lump and the histopathological report confirmed IDC (Figure 3).
PMC6180830_03
Ultrasound of the breast in orthogonal views showing a spiculated, poorly circumscribed, hypoechoic mass with posterior acoustic shadow in the left breast.
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f4
There were multiple enlarged lymph nodes with replaced hila in both axillae (Figures 4 and 5).
Ultrasound of the axilla with a replaced node showing an enlarged lymph node with irregular margins and loss of the usual corticomedullary differentiation; however, Doppler interrogation showed no increased vascularity.
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f5
There were multiple enlarged lymph nodes with replaced hila in both axillae (Figures 4 and 5).