Primary Intermammary Breast Carcinoma Presenting With Direct Sternal Invasion: A Diagnostic Pitfall of Standard Screening Mammography.

Authors

Rachel Deming, Michael Fei, Harsha Choudary Pudhota, Sonal P Haerter, Moustafa Hazin

Published in

The American journal of case reports. Volume 27. Pages e953831. Oct 15, 2026. Epub Oct 15, 2026.

Abstract

BACKGROUND Standard screening mammogram views focus on the lateral and posterior breast tissues; the view that best visualizes the intermammary area, the 90-degree lateral or cleavage view, is not typically performed. The limited field of view of mammogram increases the importance of additional imaging with CT, ultrasound, and MRI as a tool in diagnosing neoplasm in the intermammary area. To date, intermammary primary breast carcinoma has been reported only a few times in the literature, and none of these described direct sternal invasion at presentation. CASE REPORT An 85-year-old woman with a past medical history of follicular non-Hodgkin lymphoma treated with bendamustine-rituximab in 2017 (without chest radiation) and significant family history of breast cancer presented to our clinic 2 months after noticing a hard, non-tender nodule on her sternum. She had undergone a routine screening mammogram 8 months prior, which was unremarkable. Subsequent diagnostic workup including targeted ultrasound, and PET-CT identified a hypermetabolic presternal mass. Notably, diagnostic mammography 8 months after the initial screening mammogram also failed to properly visualize the lesion. Biopsy confirmed ER+/PR+, HER2- adenocarcinoma consistent with breast origin. Despite negative initial staging for distant metastasis, pathological examination after resection revealed direct invasion into the sternum, necessitating partial sternectomy. CONCLUSIONS This case highlights a rare intermammary presentation of breast carcinoma with direct sternal invasion, a feature not previously reported. It emphasizes the blind spot of standard screening mammography in the medial breast/cleavage area and the necessity of targeted imaging for palpable parasternal masses, even in the setting of recent negative screens.

PMID:
42876016
Bibliographic data and abstract were imported from PubMed on 15 Oct 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.