Breast mass (BI-RADS 4c)

Case contributed by Mohammadtaghi Niknejad
Diagnosis almost certain


Screening mammography. History of breast cancer in first-degree relatives.

Patient Data

Age: 60 years
Gender: Female

A hyperdense mass with an irregular margin is noted in the LIQ of the right breast that contains a few small calcification foci. It is accompanied by mild adjacent parenchymal distortion (BIRADS 4c).

No skin thickening or retraction.


On targeted ultrasound and color Doppler evaluation, there was a hypoechoic mass with internal hypervascularity, irregular margins, and surrounding parenchymal distortion.

Case Discussion

An ultrasound-guided core needle biopsy was performed for the right breast mass, and histopathology evaluation confirmed invasive breast carcinoma.

Malignant masses on ultrasonography often are hypoechoic and dark. The other findings are similar to mammography, although fine internal calcification foci and surrounding parenchymal distortion may not be visible on ultrasound compared to mammography.

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