Posterior Echo Enhancement by Elastosis in Breast Cancer: A Case Report

Elastosis, rarely observed in breast cancers, is a condition in which degradation products of elastin fibers, one of the fiber components, accumulate in the tumor. However, its image findings remain uncertain. A 78-year-old woman with a breast mass was referred to our hospital. Mammography showed a mass with indistinct borders and focal spiculation. Ultrasound depicted an irregular mass with very low internal and enhanced posterior echoes. MRI of the mass presented a hypo-intense pattern on T1- and fat-suppressed T2-weighted images and a persistent pattern on time-signal intensity images. After the confirmation of pathological malignancy, the patient underwent curative surgery. Postoperative pathological study showed cancer cells with marked elastosis. In conclusion, diagnostic physicians can predict the presence of elastosis in the tumor when the tumor has very low internal echoes and enhanced posterior echoes in addition to the suspected presence of massive fibrous components.