RARE Malignant Breast Pathologies with Benign Imaging Features : About Three Clinical Cases and Literature Review

Abstract

Deceptive cancers mimic benign breast tumors and are primarily represented by the group of round-shaped cancers with well-circumscribed contours. These account for about 10 to 20% of breast cancers. They most often correspond to grade III invasive carcinomas without specific features, particularly triple-negative cancers. Other etiologies of round-shaped carcinomas correspond to specific histological types including colloid (or mucinous) carcinoma, and medullary carcinoma (especially frequent in patients mutated for BRCA1). It is crucial to recognize their presentation in conventional imaging, mammography, and ultrasound, and to consider them in the presence of morphological criteria of benign appearance (cystic component in ultrasound) combined with subtle non-typical benignity criteria such as the presence of microcalcifications in mammography, microlobulated contours, a complex cystic component in ultrasound, or intratumoral vascularization in Doppler mode. In case of doubt, it is imperative to indicate a micro-biopsy for histological analysis.