The larger right breast lesion corresponding to the palpable lump was a solid hypoecohoic mass with partially circumscribed margins located at upper outer quadrant (UOQ) of right breast. Targeted ultrasound showed a 2.4 cm lobulated, hypoechoic mass with indistinct margins and increased vascularity. Also notice the radial hypoechoic projections protruding from the lesion surrounded by increased locoregional fat echogenicity (probably related to edema or local inflammatory changes).
Also in the right breast, an alternatively lesion was found at upper inner quadrant (UIQ), corresponding to an 8 mm hypoechoic nodule with irregular margins and some surrounding echogenic fat halo (characteristics similar to the previous one).
A third incidental lesion was found at left breast, located anteriorly in the 12 o’clock axis, corresponding to a 7 mm circumscribed hypoechoic oval nodule on ultrasound (low suspicion features).
No abnormal lymph nodes were identified in both axillary regions.
Right breast lesions were categorized as BIRADS 4C (palpable index lesion) and 4B (8 mm nodule) and ultrasound-guided biopsies were performed on the same day. Fourteen gauge core biopsy devices were used to obtain core specimens. Left breast lesion was categorized as BIRADS 3 but, in patient's clinical context, a delayed US-guided biopsy was performed one week later.