Fig. 5

Case number 3 of Table 3. A 54-year-old patient with a screen-detected 12-mm calcified right breast mass, a grade 3 infiltrating ductal carcinoma with associated DCIS on core biopsy. CEM: (a) low energy and (b) recombined CC views as well as (c) low energy (i) recombined MLO (i) views show a calcified rim enhancing mass (solid arrows). MRI: axial unenhanced T1-weighted (e), axial T1-weighted contrast-enhanced subtracted (f), axial, and (d, j) sagittal images show the enhancing mass (solid arrows). The additional lesion detected on MRI was a 5-mm focus of enhancement (dotted arrow) lying 15 mm antero-mediallly to the index cancer. CC mammogram (h) shows the bracketing hookwires following MRI guided insertion. Grid specimen radiograph (g): in addition to the main calcified mass, a tiny cluster of microcalcifications (dotted arrow) is noted, not visible on the initial magnification mammograms. Final pathology: the screen-detected lesion was a 10-mm unifocal grade 3 mixed micropapillary ductal carcinoma not otherwise specified and papillary carcinoma with associated DCIS. The additional lesion was a 2-mm focus of DCIS, 20 mm away from the main lesion. CC Craniocaudal, CEM Contrast-enhanced mammography, DCIS Ductal carcinoma in situ, MLO Mediolateral, MRI Magnetic resonance imaging