Breast Cancer - Arab Medical Association Against Cancer

Breast Imaging 65Figure: BIRADS 4 Metaplasic carcinomaSmall cluster of polymorphous calcificationsFigure: Suspicious Image, BIRADS 4, Biopsy : In Situ CarcinomaHIGHLY SUGGESTIVE OF MALIGNANCY IMAGES, BIRADS 5In these images, the likehood of malignity is high and the biopsy before surgery has strategic interestto precise the pathologic, immuno-histochimic or even genomic charateristics of the tumors. Butsometimes such BIRADS 5 aspects can be observed in some benign lesions like FAD. Highlysuggestive of malignancy are spiculated masses with dense centers (FIG 12), Ill defined masses withirregular margins (FIG 13), irregular spiculated masses with associated pleomorphic calcifications. Forthe calcifications, numerous fine pleomorphic calcifications, fine linear or fine-linear branchingcalcifications (FIG 14), linear or segmental distribution of calcifications whatever their morphology,are very suspect of malignancy.M a m m o g r a m :M a s s w i t h m a s k e d m a r g i n sS o n o g r a p h y :I r r e g u l a r m a s s , V e r t i c a l a x i s ,n o p o s t e r i o r s h a d o w i n gFigure: Suspicious malignant mass, BIRADS 5