Figure 3b. Images in a 40-year-old woman with history of prior contralateral cancer, with sclerosing adenosis, radial sclerosing lesion, and multiple small foci of invasive ductal (tubular) and lobular carcinoma. (a) Craniocaudal spot magnification mammogram shows 15-mm spiculated mass (arrow). (b) Photomicrograph of 11-gauge stereotactic biopsy specimen initially interpreted as only sclerosing adenosis. Because of the highly suspicious mammographic findings, excision was recommended. Second review demonstrated this associated radial sclerosing lesion at core biopsy as suggested by the central elastosis (arrowheads). (Hematoxylin-eosin stain; original magnification, x20.) (c) Low-power microscopic view of the excisional specimen shows a portion of the radial sclerosing lesion. A small (2-mm in diameter) focus of invasive ductal (tubular) carcinoma (arrow) is noted adjacent to and involving the sclerosing lesion. Other scattered foci of tumor manifested as isolated nests of cells and single cells. (Hematoxylin-eosin stain; original magnification, x15.) (d) High-power microscopic view of invasive ductal (tubular) carcinoma at excisional histopathologic examination (close-up of area marked in c). Note that individual duct profiles (arrowheads) lack an outer myoepithelial layer, which is compatible with tubular carcinoma. (Hematoxylin-eosin stain; original magnification, x40.)