med.cmu.ac.th Clinics in Diagnostic Imaging (88)

An 83-year-old man presented with an enlarging painless lump in his left breast for one year. He had history of chronic renal failure but no familial history of breast carcinoma. Physical examination revealed a 2 x 3 cm firm mass at subareolar region of the left breast. The mass was fixed to the overlying skin but it was moveable over the chest wall. There was no nipple retraction, nipple discharge, or axillary lymphadenopathy. Mild enlargement of the right breast was also noted but no mass was palpable. Laboratory investigations were: haemoglobin of 9.2 g/dl, haematocrit of 26.9%, white blood cell count of 7.8 x 103/mm3, and creatinine of 5.4 mg/dl (normal 0.7-1.5 mg/dl). What do the bilateral craniocaudal mammograms and ultrasonography (US) of the left breast show (Fig. 1)? What is the diagnosis? Fig. 1 a) Bilateral craniocaudal mammograms. b) Transverse US scan of the left breast