For each case, we have provided the relevant images, clinical data and a number of options for the diagnosis for you to choose from. Please complete the slide survey – use the Mentimeter form to enter your diagnosis, linked HERE and at foot of this page.

Please review the cases and submit your opinion by 5pm (UK time), 21 September.

Submitted responses will be used to guide the discussions in the case presentations. Respondent details will not be used or referred to.

Please keep a note of your choices as you choose them if you wish to refer to these during the slide seminars. Unfortunately we cannot provide a summary report of your submission.

To view the slide images

To open the image(s) for each case you simply click on the thumbnail image or its associated URL.

Now you can complete the slide survey in the Mentimeter Form

If you have any issues viewing the cases, please firstly try changing your browser. For any other queries, please contact Jenny Baldwin at jennifer.baldwin@nottingham.ac.uk

Case 1

Clinical Data:

69 years-old female, Chinese
Chief complaint: Right breast lump x 8 months
History: right breast mass since January 2019, no nipple discharge
P.E.: R1H 5cm FN, 1.5 cm mobile lump, pain on palpation, no axillary lymph node palpable
MMG/USG: R1H 5cm FN 1.3×1.2×1.6 cm irregular lesion low suspicion for malignancy (BIRADS 4a)
Operation: Right mastectomy with SLN biopsy (September 2019)

Diagnosis Options:

• Infiltrating duct carcinoma, no special type, with microglandular adenosis
• Adenoid cystic carcinoma
• Tubular carcinoma
• Invasive cribriform carcinoma
• Infiltrating duct carcinoma, no special type, with collagenous spherulosis

Case 2

Clinical Data:

75 years-old woman, Chinese
Chief complaint: Right breast abscess
History: Right breast swelling x 4 days, with bloody discharge, no history of trauma
P.E.: 8 cm fungating fluctuant mass in the right breast, multiple enlarged axillary LNs
MMG/USG: Right breast with ~11.2cm complex solid-cystic lesion along periareolar to lower quadrant (5-9H) with internal solid echoic to papillary growth of 7.4 cm, infiltration beyond the echoic rim at R5H confine with focal infiltration to overlying skin at R7H. Features of high suspicion.

Diagnosis Options:

• Metaplastic carcinoma
• Infiltrating duct carcinoma
• Metastatic sarcoma
• Angiosarcoma /lymphoangiosarcoma
• Florid reactive spindle cell reaction

Case 3

Clinical Data:

66 year-old woman with right breast mass

Diagnosis Options:

• Intraductal papilloma
• Invasive solid papillary carcinoma
• Invasive carcinoma associated with an encapsulated papillary carcinoma
• Tall cell carcinoma with reverse polarity with frank invasion
• Invasive carcinoma, no special type, arising in DCIS

Case 3b – HE:

https://pathpresenter.net/public/display?token=897e1cc3

Case 4

Clinical Data:

21 year-old woman with left breast mass.

Diagnosis Options:

• Metaplastic carcinoma
• Malignant phyllodes tumor
• Angiosarcoma
• Sarcoma, other
• Melanoma

Case 5

Clinical Data:

78 year-old female, 1-year history of palpable right breast mass.

Ultrasound: Hypoechoic lesion at right 9–10 o’clock, 18×16×14 mm, BI-RADS 4C.

Mammography: Spiculated nodule in right upper outer quadrant, 16 mm, BI-RADS 4C

Diagnosis Options:

• Invasive carcinoma, no special type
• Invasive apocrine carcinoma
• Acinic cell-like carcinoma
• Invasive lobular carcinoma, pleomorphic type

Case 6

Clinical Data:

64 year-old woman with a lump in the upper outer quadrant of the right breast.

Diagnosis Options:

• Encapsulated papillary carcinoma
• Benign adenomyoepithelioma
• Atypical adenomyoepithelioma
• Malignant adenomyoepithelioma in situ
• Malignant adenomyoepithelioma invasive

Case 6b – HE:

https://pathpresenter.net/public/display?token=c22d8f1c