Figure 5. A 44-year-old patient. Mammography (a-d): the breasts are heterogeneously dense, which may obscure small mases. In the upper-outer quadrant of the left breast (shown on the right), 6 cm from the nipple, a well-circumscribed 25 mm diameter lesion is seen: BI-RADS 4 on MG. US (e-f): At the 2 o'clock position in the left breast, 5 cm from the nipple, a polycystic, sharply defined hypo-echogenic lesion of dimensions 22 mm x 15 mm is observed: BI-RADS 4 on US. The same breast, centrally, 1 cm from the nipple shows a poorly differentiated hypoechogenic area (dimensions: 8 mm x 4 mm), BI-RADS 5 on US (g-j). On CESM, the right breast (displayed on the left) shows no significant enhancement. In the left breast, a strongly enhancing, well-circumscribed lesion is visible in the upper outer quadrant, 6 cm from the nipple. In the same breast, a poorly circumscribed, weakly enhancing lesion is seen on the border of the inner quadrant, 5 cm from the nipple. Histopathology (k-l): Outer quadrant - large lesion is diagnosed as pericanalicular fibroadenoma. Additionally, in the parenchyma surrounding that lesion the different proliferative epithelial changes are noticed including atypical ductal hyperplasia and a single focus 1.2 mm in diameter of ductal carcinoma in situ, cribriform type. Centrally and in the inner quadrant, the smaller lesion is diagnosed as intraductal carcinoma in situ and invasive carcinoma NST grade 2.