Mammographically occult breast cancer

A dense breast can obscure a cancer. CC and MLO views (panels A and B) in a woman with a palpable breast lump show dense breast parenchyma. No discrete mass or calcifications are seen. An MRI with contrast (panel C) in the same breast shows multiple enhancing masses (arrows) involving the upper half of the breast worrisome for malignancy. Ultrasound-guided biopsy revealed invasive ductal cancer. If there is a clinical suspicion for cancer, a negative mammogram should not stop further intervention.