Clinical History:

An elderly female presented with complaints of painless, hard, lump in breast; which was detected incidentally.

Findings and discussion:

On 2D ultrasonography, an ill-defined, oval shaped, heterogeneously hypoechoic lesion with irregular lobulated margins and increased vascularity on colour doppler study. However, no obvious intralesional calcification was evident on ultrasound. This lesion showed blue hue on strain elastography, suggesting that the lesion is hard. There was associated thickening of overlying skin.

This findings were in favour of malignant breast lesion. And hence the diagnosis of BIRADS 5 (Highly suggestive of malignancy) lesion of breast was made.

Key-points:

BIRADS provided lexicons for both ultrasound and mammography to characterize and categorize a breast lesion from benign to malignant. BIRADS lexicon can be found in further readings.