Fig. 1

Female patient 50 years old with left breast benign phylloids. A Bilateral digital mammogram (cranio-caudal view). There is a left breast upper inner focal rounded dense mass (arrow), that showed associate secondary signs suspicious of malignancy of increased density and coarsening of the surrounding parenchyma (suggestive peri-tumroal edema) and focal areolar dermal thickening. B Tomosynthesis slices of the left breast (MLO view) showed that the mass had a circumscribed margin (circle), yet there is related thickened Cooper’s ligament (arrow). C Ultrasound images displayed large about 4 cm solid mass with irregular margin and the ipsilateral axilla displayed an average sized likely reactionary lymph node (white circle). D AI scanned mammogram image marked the left breast mass in a heatmap by a faint blue/green colour hue and displayed abnormality scoring of 56% suspicion of malignancy. Such mass was diagnosed BI-RADS 4c on conventional breast imaging and malignancy was highly suspected. The mass proved to be benign phylloids by tissue core biopsy and the suspicious secondary signs of: focal tissue edema, thickened Cooper’s ligament and dermal thickening were likely due to inflammatory changes from the rapid rate of growth. AI abnormality scoring of more than 49.5% (i.e. 56%) suggested phylloids rather than fibro-adenoma and benign phylloids not malignant one since the value was less than 90%