Certain sonographic features are associated with complex fibroadenomas and can help the radiologist decide which ones require biopsy.

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Objective: To evaluate clinicopathological differences between screen-detected (SD) and interval (IC) breast cancers diagnosed in women enrolled in an organized breast screening programme in [2000][2001][2002][2003][2004][2005][2006][2007]. Setting: Breast Cancer Screening Programme of the north region of Portugal. Methods: Using data from the screening programme and from the population-based North Region Cancer Registry, SD and IC were identified. Information on screening history, age, date of diagnosis, tumour size, histological type and grade, lymph node status, tumour stage, biomarkers, and treatment was obtained from the cancer registry and from clinical and pathological reports. Association between mode of detection and these clinicopathological characteristics was estimated by unconditional logistic regression. Results: A total of 442 SD and 112 IC were identified in women aged 50-69. Compared with SD, IC were diagnosed in younger women (60.0 AE 5.8 years and 58.4 AE 6.0 years, respectively), were larger (tumour size >20 mm: 60.2% versus 25.1%), lobular (6.3% versus 16.1%), with a higher differentiation grade (grade 3: 17.7% versus 38.9%), had more lymph node metastases, more advanced stage, and oestrogen receptor (ER) negative (12.9% versus 29.0%) and progesterone negative, and HER2 positive. After multivariable analysis, compared with SD, IC were more likely to be larger than 20 mm, lobular, of grade 3 and negative for ER. Conclusion: Our results are consistent with other studies. IC's have a more aggressive biology than SDs. Our findings did not show any unexpected pattern requiring changes to our screening procedures, but continuous identification and characterization of IC is advisable.

mammograms, 15 (8%) had circumscribed masses, 12 (6%) had various focal nodular patterns and the remaining 16 patients had other mammographic signs of malignancy including asymmetry, dilated retroareolar ducts, ill-defined rounded tumor, focal architectural distortion, sub-areolar mass, and developing density.The DCIS in our patient manifests as linearly distributed microcalcifications overlying noncalcified band-like density. The band-like density represents noncalcified portions of the affected lactiferous duct surrounding the calcifications, and is better identified in digital breast tomosynthesis than in conventional mammography. We propose to call this new tomosynthesis finding the Milky Way sign because the linearly distributed fine pleomorphic calcifications over the band-like density resembled bright stars overlying the dimly glowing stripe of the Milky Way galaxy arching across the night sky. The Milky Way sign can be one of potential diagnostic tools to aid in the detection of DCIS in the context of tomosynthesis. CONFLICT OF INTERESTAuthors declare no conflicts of interest. SUPPORTING INFORMATIONAdditional Supporting Information may be found in the online version of this article:Video S1. Digital breast tomosynthesis video in CC projection shows fine pleomorphic calcifications overlying band-like linear density in the lower right breast, shown to be DCIS on biopsy.Video S2. Digital breast tomosynthesis video in MLO projection shows fine pleomorphic calcifications overlying band-like linear density in the lower right breast, shown to be DCIS on biopsy.A 62-year-old woman was referred to our Institution with the suspicion of inflammatory breast carcinoma. She presented with "orange peel" appeareance of her breast skin and slight tenderness, with 1 month of evolution. There was no history of breast injury. Her relevant medical history included chronic renal failure with an arteriovenous fistula for hemodialysis in the ipsilateral upper limb. At physical examination, there was breast asymmetry and right breast skin edema without significant erythema. There was neither palpable nodule/mass nor nipple discharge. Mammogram (Fig. 1a) revealed unilateral enlargement of the breast with stromal coarsening, diffuse increased density and skin thickening. There was no axillary lymphadenopathy. A tubular density in the upper inner breast was seen, corresponding to a dilated tortuous superficial collateral vein. Sonogram showed diffuse hyperechogenicity in the right breast, dermal and subdermal engorged lymphatics, and a noncompressible beaded tubular structure (Fig. 1b), with lack of internal color Doppler flow in the upper inner breast. Magnetic resonance images (MRI) revealed consistent findings (Fig. 2), with increased vascularization and tortuous enlarged

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