Short answers

• 1. An asymmetric density superiorly with some parenchymal deformity. Core biopsy showed an invasive lobular breast carcinoma.

• 2. A partially well defined mass inferiorly. In a patient of this age even a well defined mass suggests malignancy. Core biopsy showed an invasive ductal carcinoma.

• 3. Such patients undergo “triple” assessment—clinical examination, imaging, and, if necessary, needle biopsy in a multidisciplinary breast clinic.

Long answer

Any patient with a new breast lump should be referred to a specialist multidisciplinary breast clinic. Modern breast assessment consists of triple assessment—expert clinical examination, imaging (usually mammography and ultrasonography), and, if necessary, needle biopsy.1 The single most important risk factor for breast cancer is age, with the incidence of breast cancer rising throughout life. A patient presenting with a new discrete lump at the age of 81 years is at substantial risk of having a malignancy.2 Mammography is the first line imaging investigation for women over the age of 35 years.3 The mammographic features …