Fig. 2

A 64-year-old female patient underwent right CBS for IDC grade II, presenting with right LIQ palpable lump. A Mammography (CC and MLO views) revealed: Breast density ACR ‘b’. A hyper-dense lesion in the right LIQ shows irregular borders and multiple speculations showing skin thickening and nipple retraction (white arrow). B Complementary ultrasound revealed: an ill-defined antiparallel hypoechoic mass lesion seen in the LIQ of the right breast. C Contrast-enhanced spectral mammography revealed: enhancing mass in the right lower inner quadrant with evidence of ductal extension (white arrow). Final Diagnosis: Pathology: IDC. Final comment: In this case, both sonomammography and CESM could detect ipsilateral newly developed malignant-looking lesion with CESM also confirmed intra-ductal extension