Breast tubular carcinoma at parasternal and retro-nipple area

Introduction: Breast tubular carcinoma (TC) is a well-differentiated infiltrating ductal carcinoma, common in postmenopausal women. Patient concerns: Two patients concerned their abnormality of their breasts, one at deep parasternal higher chest wall in a 74-year-old female and the other behind the nipple in a 39- year-old female. Diagnosis: These masses were detected by mammography, ultrasound and magnetic resonance imaging (MRI) examinations. The parasternal mass identified by mammography showed long spicules along the edges of the mass. Ultrasound examination revealed that these masses had solid irregular hypoechoic nodules. The color Doppler ultrasound of the retro-nipple mass presented with increased blood flow resistance index. The dynamic contrast-enhanced MRI examination of the retro-nipple nodule demonstrated an intensely enhancing mass with a plateau-type time-signal intensity curve. Interventions: Two cases were surgically removed by local resection of foci under ultrasound guidance. Outcomes: These imaging examinations strongly suggest possible breast tubular carcinoma, which was confirmed by the pathological evaluation of frozen sections from surgically removed masses. Conclusion: Although uncommon, breast tubular carcinoma may be considered in the differential diagnosis of small solid masses with long spicules at parasternal breast or behind the nipples in adult women.