Presentation
A 35 year old mother of two presents with a palpable mass inferiorly in the right breast.
Patient Data
This is the initial MLO view of the right breast. There is a well defined smoothly circumscribed density in the inferior right breast, which is incompletely visualized.
Here are the ultrasound images of the palpable lesion. This lesion was described as a Birads 3 lesion and 6 month follow up was suggested.
This is not a simple cyst, not ever. Look at the wall of the structure. It's thick walled with internal mural nodule at 6 o'clock. There is no smooth capsule and it is almost lobulated anteriorly.
On the mammogram it's a strange place for a cyst, not that that means anything. On the ultrasound we are not dealing with a simple cyst.
Mixed echogenicity solid lesion, poorly defined and vascular.
Case Discussion
Biopsy confirmed infiltrating ductal carcinoma in a 35 year old. The case teaching point highlights how important it is to make sure a simple cyst is actually a simple cyst. Not all hypoechoic or anechoic structures in breasts are cysts.