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Developing Asymmetry Identified on Mammography: Correlation with Imaging Outcome and Pathologic Findings

¹ Both authors: Department of Radiology, University of California, San Francisco Medical Center, Box 1667, San Francisco, CA 94143-1667.

View larger version (78K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1A —67-year-old postmenopausal woman with nonpalpable developing asymmetry (visible in two projections, concave-outward contour, interspersed with fat) in left upper outer portion of breast detected on screening mammography. Diagnostic images show summation artifact. Follow-up mammograms (not shown) 24 months after screening and linkage with regional tumor registry showed no evidence of cancer. Mediolateral oblique projection mammogram of left breast obtained at previous screening shows no abnormal findings.

View larger version (68K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1B —67-year-old postmenopausal woman with nonpalpable developing asymmetry (visible in two projections, concave-outward contour, interspersed with fat) in left upper outer portion of breast detected on screening mammography. Diagnostic images show summation artifact. Follow-up mammograms (not shown) 24 months after screening and linkage with regional tumor registry showed no evidence of cancer. Craniocaudal projection mammogram of left breast obtained at previous screening shows no abnormal findings.

View larger version (102K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1C —67-year-old postmenopausal woman with nonpalpable developing asymmetry (visible in two projections, concave-outward contour, interspersed with fat) in left upper outer portion of breast detected on screening mammography. Diagnostic images show summation artifact. Follow-up mammograms (not shown) 24 months after screening and linkage with regional tumor registry showed no evidence of cancer. Mediolateral oblique projection mammogram of left breast 19 months after A and B suggests presence of asymmetry (arrow) not previously present in upper aspect.

View larger version (81K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1D —67-year-old postmenopausal woman with nonpalpable developing asymmetry (visible in two projections, concave-outward contour, interspersed with fat) in left upper outer portion of breast detected on screening mammography. Diagnostic images show summation artifact. Follow-up mammograms (not shown) 24 months after screening and linkage with regional tumor registry showed no evidence of cancer. Craniocaudal projection mammogram of left breast in 19 months after A and B suggests presence of asymmetry (arrow) not previously present in outer aspect.

View larger version (159K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1E —67-year-old postmenopausal woman with nonpalpable developing asymmetry (visible in two projections, concave-outward contour, interspersed with fat) in left upper outer portion of breast detected on screening mammography. Diagnostic images show summation artifact. Follow-up mammograms (not shown) 24 months after screening and linkage with regional tumor registry showed no evidence of cancer. Mediolateral oblique projection spot-compression magnification mammogram of developing asymmetry shows only superimposition of fibroglandular structures.

View larger version (153K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1F —67-year-old postmenopausal woman with nonpalpable developing asymmetry (visible in two projections, concave-outward contour, interspersed with fat) in left upper outer portion of breast detected on screening mammography. Diagnostic images show summation artifact. Follow-up mammograms (not shown) 24 months after screening and linkage with regional tumor registry showed no evidence of cancer. Lateromedial projection spot-compression magnification mammogram of developing asymmetry shows only superimposition of fibroglandular structures.

View larger version (80K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2A —39-year-old premenopausal woman with palpable lump in right upper breast. Core biopsy revealed pseudoangiomatous stromal hyperplasia. Mediolateral oblique projection mammogram of right breast at baseline shows no abnormal findings.

View larger version (87K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2B —39-year-old premenopausal woman with palpable lump in right upper breast. Core biopsy revealed pseudoangiomatous stromal hyperplasia. Mediolateral oblique projection mammogram of right breast 1 year after A shows right breast with developing asymmetry (marked by metallic BB) in upper aspect that corresponds to presenting symptom of palpable lump. Developing asymmetry was located in central aspect in craniocaudal projection (not shown). Sonogram (not shown) showed vague hypoechoic focus.

View larger version (154K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2C —39-year-old premenopausal woman with palpable lump in right upper breast. Core biopsy revealed pseudoangiomatous stromal hyperplasia. Mediolateral oblique projection spot-compression magnification mammogram of right upper breast shows persistence of asymmetry but no underlying mass, calcifications, or architectural distortion. Concave outward margins (arrows) and interspersed fat are evident.

View larger version (88K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2D —39-year-old premenopausal woman with palpable lump in right upper breast. Core biopsy revealed pseudoangiomatous stromal hyperplasia. Contrast-enhanced maximum-intensity-projection sagittal MR image of right breast shows regional enhancement in upper aspect that corresponds to palpable lump and developing asymmetry on A-C.

View larger version (88K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3A —60-year-old postmenopausal woman with nonpalpable developing asymmetry in left upper outer portion of breast detected on screening mammography (visible in two projections, concave-outward contour, interspersed with fat). Core biopsy revealed invasive ductal carcinoma. Mediolateral oblique projection mammogram of left breast at screening shows developing asymmetry (arrow) in upper aspect. This asymmetry was not present on previous screening mammography (not shown).

View larger version (62K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3B —60-year-old postmenopausal woman with nonpalpable developing asymmetry in left upper outer portion of breast detected on screening mammography (visible in two projections, concave-outward contour, interspersed with fat). Core biopsy revealed invasive ductal carcinoma. Craniocaudal projection mammogram of left breast shows developing asymmetry (arrow) in outer aspect. This asymmetry was not present on previous screening mammography (not shown).

View larger version (140K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3C —60-year-old postmenopausal woman with nonpalpable developing asymmetry in left upper outer portion of breast detected on screening mammography (visible in two projections, concave-outward contour, interspersed with fat). Core biopsy revealed invasive ductal carcinoma. Mediolateral oblique projection spot-compression magnification mammogram of left upper breast shows persistence of developing asymmetry (arrow) but no underlying mass, calcifications, or architectural distortion.

View larger version (133K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3D —60-year-old postmenopausal woman with nonpalpable developing asymmetry in left upper outer portion of breast detected on screening mammography (visible in two projections, concave-outward contour, interspersed with fat). Core biopsy revealed invasive ductal carcinoma. Craniocaudal projection spot-compression magnification mammogram of left outer breast shows persistence of developing asymmetry (arrow) but no underlying mass, calcifications, or architectural distortion.

View larger version (161K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3E —60-year-old postmenopausal woman with nonpalpable developing asymmetry in left upper outer portion of breast detected on screening mammography (visible in two projections, concave-outward contour, interspersed with fat). Core biopsy revealed invasive ductal carcinoma. Transverse sonogram shows irregular hypoechoic mass (arrow) with angular margin corresponding to developing asymmetry on A-D.

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