Fast Five Quiz: Breast Cancer Presentation and Diagnosis

Pavani Chalasani, MD, MPH; Stefania Morganti, MD


January 11, 2023

Calcifications may be the first sign of cancer and, when present, are described using the Breast Imaging Reporting and Data System (BI-RADS) lexicon on the basis of their morphology and distribution. Suspicious calcifications, or BI-RADS category 4, tend to be more irregular and smaller in size. Morphologically, they are described as amorphous, fine pleomorphic, coarse heterogeneous, or fine-linear branching. In addition, calcifications with linear or segmental distributions have a greater probability of malignancy. Although the features of benign and malignant masses can be similar, malignant lesions often have irregular, indistinct, or spiculated margins, whereas benign lesions are often round or oval with circumscribed margins.

A well-circumscribed, hypodense, oval mass on mammography may be suggestive of a fibroadenoma. Although they can occur at any age, fibroadenomas typically occur in women between the ages of 14 and 35 years.

Breast cysts are very common. Cysts are fluid-filled masses, unlike cancerous tumors, which are typically solid.

Breast density is defined by the amount of fibroglandular tissue relative to fat. Although dense breast tissue is associated with an increased risk for breast cancer, it is typically not an imaging finding consistent with breast cancer.

Learn more about the presentation and diagnosis of breast cancer.


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