Fig. 1.

A. Sonography from June 2003 shows a 12 mm irregular mass (calipers) at the medial portion of the left breast.

B. The histopathologic findings from the left breast surgical specimen shows an intraductal papilloma (Hematoxylin & Eosin staining, ×100).

C. Follow-up sonography, from March 2004, shows an irregular mass with internal heterogeneous hyperechogenicity. An anechoic portion (thick arrow), suggestive of fat necrosis, was noted, and the mass abutted the thickened skin (thin arrow) from the previous excision.

D. The third follow-up sonogram from March 2005, demonstrates that the irregular mass decreased in size, from 15 mm to 10 mm.

E. The fourth follow-up sonography from September 2005, showing that the mass had developed a new angular margin (arrows) in one portion (right split-screen image: transverse view, left split-screen image: longitudinal view).

F. On Doppler ultrasound, penetrating vascularity (arrow) was detected.

G. On compression mammography of the craniocaudal view, a 4 mm mass (arrow) is seen just beneath the skin scar.

H. On tissue confirmation, the surgical specimen demonstrates a 4 mm infiltrating ductal carcinoma (arrows) in the peripheral portion of the excised specimen with marked fibrosis and foreign body reaction in the majority of the specimen (Hematoxylin & Eosin staining, ×100).