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