Findings: There is in the central and slightly superior aspect of the left breast a 1.5 cm mass that correlates with a clinically palpable finding. The margins are microlobulated suggesting a high suspicion for malignancy. There are no associated microcalcifications.

Diagnosis: Microlobulated ductal carcinoma insitu.

Discussion: Many well-circumscribed lesions within the breast have a degree of lobulation. Fibroadenomas, for example, usually are not perfectly round and smooth but of undulating lobulated margins. The more lobulated the lesion (lobulations per surface area) and the smaller the undulations, however, the more likely it is to be malignant. When the lobulations are multiple and only several mm in size, a degree of suspicion for cancer should be increased.

Some have described this microlobulation as knobby. The ACR BIRADS prefers the term microlobulated margin. This morphological characteristic is a strong indication of cancer but once again not pathognomonic because benign masses can have similar margins.

References:
Kopans DB. Breast Imaging, 2nd Edition. Lippincott-Raven,
Philadelphia; 1998:295.

Dahnert W. Radiology Review Manual, 2nd Edition.
Williams & Wilkins, Baltimore; 1993:335.

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