Mammographic Evaluation

of Mass

Malai Muttarak,MD
Department of Radiology
Chiang Mai University
Thailand

Definition of mass
A space-occupying lesion that is
seen in two different projections
If seen only one projection
Call it asymmetry
Characters
Shape, margin, and density

Round

Oval

Shape
Lobular

Irregular

1
 Round or Oval

Lobular
Undulating contour

Lobular

Lobular

2
 Irregular
Unable
characterized by
any of the above

Circumscribe

Microlobulated

Margin Obscured

Indistinct

Spiculated

Circumscribed
Well-defined or sharply-defined
At least 75% of margin must be well
defined, with the remainder no worse
than obscured by overlying tissue
If there is any portion of border is
indistinct or spiculated, should be
classified on the basis of the latter

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 Circumscribed

Microlobulated
Short cycles
produced small
undulations
Microlobulated

Obscured
Hidden by superimposed or adjacent
normal tissue
Believes that mass is circumscribed,
but the margin is hidden

4
 Obscured

Indistinct or ill-defined
Poor definition or the margin
Any portion raises concern that there
may be infiltration by lesion
Not likely cause by superimposed
normal breast tissue

5
 Spiculated
Lined radiating from margin of mass

Spiculated

Density
Compared to the surrounding
fibroglandular tissue
The higher density relative to the
size of mass, the more suspicious
for malignancy
Fat-containing breast masses are
benign

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 Density
1. High density
2. Equal density (isodense)
3. Low density, but not fat-containing
4. Fat-containing radiolucent

Intramammary lymph node

Lipoma

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 Hamartoma
(Fibroadenolipoma)

Oil cyst

Galactocele

8
 Differential diagnosis of
mass with indistinct or
spiculated margin
Carcinoma
Post-operative scar
Radial scar
Sequelae of abscess, hematoma,
fat necrosis
Sclerosing adenosis
Fibrosis

DDx of circumscribed mass

Cyst
Fibroadenoma
Papilloma
Phyllodes tumor
Organized hematoma
Carcinoma: primary and metastasis

DDx of fat-containing breast

masses
Intramammary LN
Lipoma
Hamartoma
(Fibroadenolipoma)
Oil cyst
Galactocele

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 Conclusion

Thank You for your attention

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