case_images: PMC11663975_01
case_images: Ultrasound of left breast shows interval development of increase in skin thickness and parenchymal fuzziness with minimal edema and increased echogenicity especially in the peri areolar region with tenderness. Interval development of a few new ductal segments with internal non-homogenous avascular echoes.
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case_images: An ultrasound was performed which revealed a decrease in the size of LUQ lesion to 19 x 14 mm from 25.7 x 25 m but there was an increase in the size of lymph nodes and the internal development of the ductal segments (Fig. 1).
case_images: CT scan: interval development of asymmetric enhancement in the upper half of the right breast measuring 34 x 22 mm. Interval increase in the left axillary lymphadenopathy, the largest node measuring 12 mm in short axis.
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case_images: The CT scan showed ductal development and left axillary lymphadenopathy (Fig. 2) leading to a revised plan of performing modified radical mastectomy (MRM) under the impression that disease has progressed during neoadjuvant chemotherapy.
case_images: Ultrasound of right breast before treatment shows retro areolar dilated duct with internal avascular echogenic material at 6'o clock.
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case_images: On the day of the procedure, a tender area was noted in the right breast 4 x 5 cm in size which was biopsied during surgery and labeled inflammatory on ultrasound (Fig. 3).
case_images: Ultrasound of right breast after conservative treatment showed improvement.
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case_images: The case was discussed in multidisciplinary team (MTD) meeting, and the decision was made to complete the remaining cycles of THCP chemotherapy, which the patient did, followed by radiotherapy (Fig. 4).
case_images: Histological slide showing granuloma formation centered around lobules.
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case_images: Histopathological examination confirmed the diagnosis of idiopathic granulomatous mastitis in the right breast (Fig. 5).