Carcinoma breast - complex cyst

Case contributed by Dr Garth Kruger


A 35 year old mother of two presents with a palpable mass inferiorly in the right breast.

Patient Data

Age: 35 years
Gender: Female

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.

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Case information

rID: 21370
Published: 19th Jan 2013
Last edited: 14th Aug 2019
System: Oncology, Breast
Inclusion in quiz mode: Included