Case 13 Answer 2
BI-RADS 5, Highly suggestive of malignancy. The spot magnification views show that both of these foci have spiculated margins.
Pathology revealed invasive lobular carcinoma. Lobular tumors are notorious for hiding within breast tissue. They grow into the stroma in single file, insinuating into the tissue such that often the usual signs of cancer such as a spiculated mass are not appreciated. Do you think it was present on the prior films?
Lets say you are reading this baseline mammogram and identify a Focal Asymmetry in the upper, slightly inner right breast. Spot magnification views fail to demonstrate any definite distortion or mass. What would your assessment be?
- BI-RADS 0 - Recommend additional imaging - targeted breast ultrasound
- BI-RADS 1 - Normal - normal interval follow-up in 12 months
- BI-RADS 2 - Benign - normal interval follow-up in 12 months
- BI-RADS 3 - Probably Benign - 6 month follow-up
- BI-RADS 4 - Suspicious - recommend image-guided needle biopsy
- BI-RADS 5 - Highly suggestive of malignancy - recommend image-guided needle biopsy