Friday, October 18, 2013

Ultrasound Case Review 2: Breast masses



Elastoscan image

History

A 34 years old female who has just noticed a newly growing lump in her right breast. She was then called up NR for a breast ultrasound appointment.

Ultrasound findings

The ultrasound showed a rounded, inhomogenous solid lesion detected at 9 o'clock, 6cm distance to nipple. 
The lesion appears isoechoic to surrounding breast tissue with a hypoechoic rim seen and some suspicious extensions beyond the hypoechoic rim.
Intralesional vascularity is also detected. Size of this lesion is 1.13 x 1.08 x 1.21cm. 
Elastoscan demonstrated that the solid lesion is stiff. 
These findings are consistent with BIRADS-4 solid lesion.

Further management

Management of breast masses on ultrasound (BIRADS-4):
  1. Newly or enlarging solid mass with benign features.
  2. Solid mass with suspicious features (irregular shape, microlobulated, ill-defined, non-parallel orientation, sonographic distortion, calcification, and associated with abnormal ducts).
  3. Complex mass (contain both solid and cystic components).

(Harvey, J.A. & March, D.E. (2013). Making The Diagnosis: A Practical Guide To Breast Imaging. Philadelphia: Elsevier Saunders.)

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