History:

The patient presented with a palpable mass in the breast. The mass has grown rapidly over the past few weeks, raising concern for malignancy. Family history includes breast cancer.

Ultrasound Findings and Description:

●     There is a solid, hypoechoic mass with irregular borders and posterior acoustic shadowing is seen in the left breast. It measures 2.5 cm x 1.8 cm x 2.0 cm.

●     Increased vascularity with low resistance velocity within the mass on Doppler ultrasound.

●     No suspicious axillary lymphadenopathy noted.

●     BI-RADS Category:BI-RADS 5 (Highly suggestive of malignancy).

Diagnosis: Breast malignancy, BI-RADS 5

Differential Diagnosis:

1. Invasive Ductal Carcinoma: Irregular shape, hypoechoic, and posterior shadowing are typical features. Highly suspicious given rapid growth and increased vascularity.

2. Invasive Lobular Carcinoma: While typically more challenging to detect on ultrasound, this type of cancer may present with an ill-defined, hypoechoic mass.

3. Phyllodes Tumor: This rare breast tumor can appear solid with well-defined or lobulated margins but may present with rapid growth.

Conclusions:

●     Solid, irregular hypoechoic breast mass with features highly suggestive of malignancy (BI-RADS 5).

●     Biopsy is recommended for histopathological confirmation.

References:

●     Radiopaedia: Breast Ultrasound BI-RADS classification and breast masses evaluation guidelines.

●     American College of Radiology BI-RADS Atlas, 5th Edition.