Supplementary Material for: Image findings of breast cancer-related elastosis: A case report

A 70-year-old woman visited the Rinku General Medical Center for the evaluation of her left palpable breast tumor. Mammography (MMG) showed an irregular mass with segmental distribution of pleomorphic calcifications. The tumor was more clearly depicted on cranio-caudal (CC) MMG than on medio-lateral-oblique (MLO) MMG. Ultrasound showed a lobulated mass with low internal echoes, echogenic spots, and at least focally enhanced posterior echoes. Magnetic resonance imaging (MRI) of the tumor showed low signal intensity on T1-weighted images and no high signal intensity on T2-weighted images and a rim enhancement pattern on subtraction images. Pathological examination of the core needle biopsy specimen showed atypical cells growing in a tubule forming fashion. The patient underwent mastectomy and, due to the cytologically proven lymph node metastasis, axillary dissection. Postoperative pathological study showed that the tumor had large elastosis areas encompassed by malignant cells. Diagnostic physicians should note that breast cancer-related elastosis is more clearly depicted on CC MMG than on MLO MMG, has possible enhanced posterior echoes, and shows low and no high signal intensities on T1-and T2-weighted images, respectively.