However, everyones experience of breast cancer is different. Fibroids are solid masses that are normally made up of fibrous connective tissue and smooth muscle. Solid mass: Have your doctor show you the image that confirmed the above mass. Follow-up scans help to ensure that if there is a new growth, its caught and treated as early as possible. However, hard cysts have a higher chance of being malignant than cysts filled with fluid. . Ultrasound rarely shows frank distortion after benign breast biopsy but can reveal an irregular hypoechoic mass with posterior shadowing. And while most of these conditions arent life threatening, some are linked with a higher risk of developing breast cancer. Also, its important to know that benign growths tend to be referred to as lesions, while cancerous growths in the breast are called carcinomas. You may not require treatment at all. Radiology. Wow. Sometimes biopsies are necessary. Review of the mammogram is essential when interpretation of an ultrasound is performed. But violence also can show as isoechoic hyperechoic lesions on or breast ultrasound, so it is not a rigid rule in any way. Discrimination of malignant and benign breast masses using automatic segmentation and features extracted from dynamic contrastenhanced and diffusionweighted MRI. Management BI-RADS assessment category 4, suspicious; biopsy should be considered. Hypoechoic means an area looks darker on ultrasound than the surrounding tissue. ACTA INFORMATICA MEDICA: "Application of Ultrasound in Medicine. It is difficult to comment more specifically on the significance of 'hypoechoic' without . Ultrasound demonstrated a 1.2 1.3 0.9 cm irregular, hypoechoic, nonparallel mass with posterior acoustic shadowing and a possible cystic component peripherally (Figs. Some lifestyle choices can make a big difference when it comes to your mental and physical well-being. Harmonics can also be used to image cysts or ducts and can help determine if a "lesion" is a true finding or not. Masses can be hypoechoic, hyperechoic, anechoic, or mixed.. American Cancer Society. Breast masses have distinct qualities when viewed by using mammogram, MRI, or other imaging techniques. Some masses may appear spiculated with posterior acoustic shadowing. We use cookies on our website to give you the most relevant experience by remembering your preferences and repeat visits. AJR American Journal of Roentgenology. Created for people with ongoing healthcare needs but benefits everyone. Many people have thyroid nodules (lumps). Instead, you may see redness, swelling, and sometimes a rash on the skin of the breast. Subsequent biopsy . The surrounding tissue therefore looks brighter/lighter shades of grey. The tumors that grow from these types of breast cancer are reflected in their names: invasive ductal carcinoma and invasive lobular carcinoma. Oncology Letters. Cystic lesions in the breast commonly present in women aged 30-50 years. This appears on an ultrasound scan as a hypoechoic mass with smooth edges. Doru Paul, MD, is triple board-certified in medical oncology, hematology, and internal medicine. Your nipple is inverted, meaning it points into your breast instead of pointing out. This appears on an ultrasound scan as a hypoechoic mass with smooth edges. They use this information to assign values to the TNM staging system, where: The overall stages of cancer range from 0 to 4. What does a hypoechoic mass look like on an ultrasound? Benign breast lesions that mimic cancer: Determining radiologic-pathologic concordance. Breast cancer, ultrasonography. Benign growths can cause pain, obstruction, and other complications. Breast cancers with hormone receptors are far more likely to respond to hormone therapy. Surgery may be the best option to remove larger hypoechoic masses. The mass is much easier to see with harmonics on. Clinical and ultrasonographic features of male breast tumors: A - PLOS 2005-2023 Healthline Media a Red Ventures Company. Read more for our picks and how to choose the best test for. That means the tissue is dense. A breast specialist may recommend removing the benign tumor if it threatens to push against internal structures and cause damage. What is a hypoechoic lesion in the breast? These type of nodules are usually solid rather than a fluid-filled lesion. These cookies help provide information on metrics the number of visitors, bounce rate, traffic source, etc. If youre under the age of 50 and are considered at higher risk, talk with a doctor about when and how often you should undergo screening. Echogenic Breast Masses at US: To Biopsy or Not to Biopsy? This means a sample is taken out, either by using a needle or through a cut in the skin. The most important features on a breast ultrasound are the smoothness and contour of the mass margins and the shape of the mass. Certain lesions may also require careful monitoring depending on your age and other risk factors for breast cancer. We avoid using tertiary references. angiomyolipoma of the breast 3: rare lesion. What is the meaning of hypoechoic lesion? - Wise-Answer Cysts are filled with air, pus, or fluids, and are usually benign. 1-2 Assessment of masses on ultrasound is guided by the Breast Imaging Reporting and Data System (BI-RADS) and evaluation includes shape, margin, orientation, echotexture, posterior acoustic changes and . In some cases, no treatment may be necessary, and your doctor may recommend monitoring the lesion over time. Fig. 2004-2023 Healthline Media UK Ltd, Brighton, UK, a Red Ventures Company. Hypoechoic is a physical description of a breast mass or cyst that is discovered by ultrasound. Others may be removed for cosmetic reasons. MX means that the doctor was unable to assess metastasis. It can help them to determine whether a lump is a breast cancer tumor or a benign mass. T3: The tumor is larger than 5 cm in width. However, correlation with the mammographic appearance, lesion location, and clinical history allows the need for biopsy to be determined. Imaging findings and classification of the common and - SpringerOpen If an ultrasound finds a hypoechoic mass, you may have wondered what that means.. The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional". Learn more. [28, 31, 32, 33] Some cancers can mimic benign tumors and appear well defined. Ultrasound demonstrates an oval hypoechoic wider-than-tall mass. Inflammatory breast cancer. Some of the features that show as a hypoechoic mass on ultrasound that are indicative of a malignant breast mass include: or a duct extension. 7 How is sonomammography used to diagnose breast cancer? Other malignant causes include: Ultrasound scans are particularly important in examining the kidneys, and changes in the tissues can be easily seen. What does heterogeneous hypoechoic nodule mean? Ultrasound features of desmoid tumor mimic those of breast carcinoma, including a hypoechoic mass with lobulated, ill-defined borders and a thick, hyperechoic rim. It is also used to help diagnose masses found on a mammogram. Metastasis is when cancer spreads from its original location in the breast to distant parts of the body, such as the liver, lungs, brain, or bones. Breast | SpringerLink The majority of breast lesions detected by ultrasound are hypoechoic. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. What is a hypoechoic lesion in the breast? - Sage-Advices However, a healthcare provider should evaluate and diagnose any changes that cause you concern. Papillary breast lesions are rare breast tumors that comprise a broad spectrum of diseases. Many women with fibroids have no symptoms. Silkowski, C. Emergency Medicine Sonography: Pocket Guide to Sonographic Anatomy and Pathology, Jones and Bartlett, 2010. and spiculation, which probably has the highest positive predictive value for malignant breast cancer. Regular checkups are important, because you may not have any symptoms at all. This is the amount of sound waves that are reflected or echoed back. Is a solid breast mass always cancer Updated Hyperechoic masses are not as dense as hypoechoic ones are. These cookies track visitors across websites and collect information to provide customized ads. If theres any doubt about a diagnosis, your doctor may recommend surgery to remove it. whether the cancer is ER-positive, PR-positive, or HER2-positive for example, surgery, which may involve a mastectomy, removal of one or both breasts, or the removal of any affected lymph nodes, the location of the cancer and whether it has spread. According to the American Cancer Society (ACS), doctors use the following system to grade tumor size: Tumor size is just one of several factors that doctors consider when determining the stage of a persons breast cancer. Or, a hypoechoic mass may shrink on its own. A 2000 study found no association of caffeine to breast density. DOI: Gerst S, et al. That contrast helps radiologists detect small cancers. Case 2. In fact, its estimated that at least 20 percent of females may develop breast lesions, though males may also be affected. BreastCancer.org. They're also not likely to be painful, though they can be in some cases. The rise in signal intensity is slow, meaning the image becomes bright very slowly and it doesn't wash out. American Cancer Society. Irregular hypoechoic masses in the breast do not always indicate malignancies. and spiculation, which probably has the highest positive predictive value for malignant breast cancer. Four cases of echogenic breast lesions: a case series and review During a breast MRI, a contrast agent is injected into the bloodstream. You might feel an unusual lump or bump during a monthly breast self-examination. This term means "not many echoes." ", National Institute of Biomedical Imaging and Bioengineering: "Ultrasound.". A fibroadenoma (fy-broe-ad-uh-NO-muh) is a solid breast lump. Cardiovascular health: Insomnia linked to greater risk of heart attack. Cancers often appear bright when looking at mammogram pictures. Baek SE, Kim MJ, Kim EK, Youk JH, Lee HJ, Son EJ. Most benign and malignant masses in the breast are hypoechoic. Things that bounce back some strong echos, show-up BRIGHT on the ultrasound. (A) Left radial breast sonogram. Because early . Six-month follow-up appropriate for BI-RADS 3 findings on mammography They usually give the size in millimeters (mm) or centimeters (cm). There are numerous types of lesions that may develop, with some producing symptoms, such as pain and swelling, with others showing no symptoms at all. DOI: 10.4103/0970-9371.112658, Wilde S, et al. Irregular hypoechoic masses in the breast do not always indicate malignancies. American Cancer Society. Doctors describe breast cancer that has receptors for estrogen as being estrogen receptor-positive, or ER-positive. Solid breast nodules: use of sonography to distinguish between benign and malignant lesions. What do hyperechoic and hypoechoic mean? It doesnt always mean that something is wrong. Benign lumps are softer, squishy, and tend to move around. Article. Early detection increases the chances of successful medical treatment. Breast ultrasonography revealed an ill-defined hypoechoic irregular mass with peripheral vascularity in the subareolar portion (Figure 2A). This test allows quick visualization of the breast tissue. After assessing the different characteristics of the breast cancer, doctors use the information to determine its overall stage from 04. A breast cancer tumor on a mammogram is often irregular. That's also true for an open biopsy done by making a cut through the skin to remove the sample. Some benign masses can be hypoechoic and may look like cancer. Learn how we can help. What does heterogeneous hypoechoic nodule mean? - Sage-Advices In some cases, a benign mass may become cancerous, or rupture and cause bleeding inside the body. It will not perform metastasis, which is the process of cancer spreading to nearby tissues and organs to form new tumors. Objective The purpose of this study was to determine clinical and ultrasonographic characteristics of male breast tumors. A spiculated breast mass, with spikes that extend out from the main mass, is a strong signal that suggests cancer. Male breast hosts various pathological conditions just like "female breast." However, histo-anatomical diversities with female breast lead to many differences regarding the frequency and presentation of diseases, the radiologic appearance of lesions, the diagnostic algorithm, and malignity features. These can spread to nearby breast tissues, and from there, move into other areas of the body. Palpable Masses after Mastectomy: Differentiating Benign Postoperative Ultrasound uses SOUND, sound-waves that bounce back as an echo. DOI: 10.4103/0971-3026.54887. Any enhancement is usually minimal or patchy. We avoid using tertiary references. Complex cystic breast masses in ultrasound examination Other uncategorized cookies are those that are being analyzed and have not been classified into a category as yet. Doctors dont like to do mammograms first, in really young women, because of radiation. What Is the Hypoechoic Thyroid Nodule? - Verywell Health Ultrasound is the most used imaging modality. A brighter rim on the outside of the mass is also common. You can learn more about how we ensure our content is accurate and current by reading our. Other ultrasound findings that suggest breast cancer include: (2007) ISBN:0781764335. (2009). Anechoic. This often indicates that a nodule is full of solid, rather than liquid, components. M refers to whether the cancer is metastatic, which means if it has spread to distant parts of the body. Some of the features that show as a hypoechoic mass on ultrasound that are indicative of a malignant breast mass include: or a duct extension. In patients under the age of 30 years,ultrasound is the primary imaging modality. intramammary lymph node with prominent central fat replacement of the hilum: partly hyperechoic. Dtsch Arztebl Int. that ultrasound is showing a definite cancer. Doctors use multiple tests and examinations to evaluate the specific characteristics of a persons breast cancer. Additionally, its important to follow your doctors recommendations for breast cancer screenings. Radiology. The symptoms of metastatic breast cancer depend on which organs the cancer has spread to, and they can vary greatly. Can Breast Cancer Be Detected in a Complete Blood Count (CBC)? Ultrasound waves cannot see through the skull and other bony areas as well as they can in softer, tissue areas. Lippincott Williams & Wilkins. This term is used to describe what is seen on an ultrasound scan. Sonographic Evaluation of Benign and Malignant Breast Masses They have an irregular shape and size. 1995;196 (1): 123-34. This article looks at treatment, life expectancy, Papillary breast cancer is a rare form of breast cancer that is characterized by long, thin tumors similar to finger-shaped growths. Scientists dont know for sure why this is true. focal fibrosis involving the breast. Figure Ultrasound-guided core needle biopsy was performed, A nodule in her left breast, which had been seen during the first screening episode, had increased from 4 mm to 9 mm (Figs. Finding breast. [ 3] Gynecomastia and invasive ductal carcinoma (IDC) are classified as the usual male breast masses; other circumstances can then be considered unusual lesions. It was a 10 10 8 mm, irregular, indistinct and heterogeneous hypoechoic mass, which had no posterior shadowing. b A spot image of iodine 123 total body scan of the neck demonstrate a focus of abnormal radiotracer . This term is used to describe what is seen on an ultrasound scan. and spiculation, which probably has the highest positive predictive value for malignant breast cancer. Ultrasound reports assume that there is low echo mass or nodules, or low echo lesions in the chest. Students, learn to love the curves and flow of things it will help you notice more abnormalities. On an ultrasound report, the term "hypoechoic" refers to an area that appears darker in the images. Only 3% to 6% of breast lumps are due to breast cancer. (L12-5 MHz, Canon Aplio 500, Japan). Immediately inform your doctor if you have any signs or symptoms, such as: See your doctor if you feel or see anything out of the ordinary. Hard cysts are more likely to be cancerous. Celli N, et al. A hypoechoic nodule refers to a dark lesion seen on ultrasound. The diagnostic accuracy of hypoechoic solid masses was significantly higher than those of the . Despite the benign ultrasound appearance, this was a new finding on mammography and ultrasound guided biopsy was performed. You just never know who might be just a few weeks pregnant. Breast cancer is usually located in the ducts and lobules of the breast, although it can start in different areas, including the connective tissue. The benign lumps sometimes resolve on their own. All rights reserved. Ultrasound (US) lexicon of the Breast Imaging Reporting and Data System (BI-RADS) defines an echogenic breast mass as a lesion that is hyperechoic in comparison with subcutaneous adipose tissue. The pathologist looks at the size and shape of the cells, as well as their arrangement if the tissue sample was taken by using a core needle biopsy. Healthcare professionals categorize lymph node status using the N value of the TNM system, where: Higher values indicate the involvement of more lymph nodes. These centers will stain darker with special dyes. Can Combined Screening of Ultrasound and Elastography Improve Breast Cancer Identification Compared with MRI in Women with Dense Breasts-a Multicenter Prospective Study. The examination is often done along with mammography (x-ray of breast tissue) to study a mass or lump. 64-year-old with a new mass in the breast also identified on screening mammography (not shown). Since it is a circumscribed mass surgical removal should not be a problem. In some cases, a benign mass may become cancerous, or rupture and cause bleeding inside the body. Breast lumps: A breast lump is a growth of tissue that develops within your breast. (2007). In this article, we discuss what a breast lesion is, what causes them to develop, and whether a noncancerous lesion is at risk of becoming cancerous. Stage 0 means the breast cancer is at a very early stage and has not yet spread. Read about types of biopsies, preparation, recovery, costs, and what the results mean. They typically form as a single spot in the liver, but some people may have more than one. infections, trauma, and inflammatory conditions, 25 percent of hypoechoic masses in the kidneys, upmc.com/Services/liver-cancer/conditions/Pages/benign-liver-masses.aspx, radiologyassistant.nl/en/p460f9fcd50637/solitary-pulmonary-nodule-benign-versus-malignant.html, appliedradiology.com/articles/benign-breast-lesions-that-mimic-cancer-determining-radiologic-pathologic-concordance, veterinaryradiology.net/4161/what-do-hyperechoic-and-hypoechoic-mean/. Hypoechoic Mass: In the Liver, Breast, Kidney, and More - Healthline Hansen KL, et al. Notice an unusual lump? Pathology Leiomyoma. Also, while these benign lesions are unlikely to be life threatening, your doctor may monitor them for possible signs of malignancy in the future. The hypoechoic Mass - Solid breast nodule or Lump - Breast Cancer Papillary breast cancer is a rare and slow-growing type of breast cancer. Cancerous masses may contain more than one type of tissue. Surgery may be the best option to remove larger hypoechoic masses. These rounded lesions are the result of accelerated cell . What are hyperechoic lesions? - TeachersCollegesj The nucleus (center) of cancer cells can be striking, with nuclei that are larger and irregular in shape. it does show some enhanced through sound transmissionbut, given that it is palpable, tender,and lobular, its biopsy is warranted conclusion :suspicious. This term means "lots of echoes." This technique requires tiny surgical incisions or none at all. Its not a measurement or a diagnosis. Healthcare professionals classify cancer cells that are close to resembling healthy cells as being low grade or well-differentiated. Moffitt Cancer Center. Analytical cookies are used to understand how visitors interact with the website. Just had my second mammogram + ultrasound and this is the finding in the report. Atlas of mammography. Some benign types are: A cluster of hypoechoic masses in the liver may be caused by cancer that has spread from another part of the body. A hypoechoic nodule is an area of swelling or abnormal cell growth on the thyroid. Thank you, {{form.email}}, for signing up. Learn about symptoms, risk factors, treatment, and more. Can poor sleep impact your weight loss goals? it is minimally heterogeneous. Reference article, Radiopaedia.org (Accessed on 04 Mar 2023) https://doi.org/10.53347/rID-1014. A hypoechoic breast mass may be benign, as in the case of a non-cancerous tumor called a fibroadenoma. How are breast lesions typicallytreated? It is an imaging technique that is used to examine and screen for cancer or/and other breast abnormalities. Role of contrast-enhanced ultrasonography in primary hepatic lymphoma. But opting out of some of these cookies may affect your browsing experience. On mammogram they appear as masses that can be associated with microcalcifications. The sur. This involves a process called fine needle aspiration (FNA), where a small needle is inserted into the lesion and a sample is collected to send off for further lab analysis. Numerous studies have shown that with ultrasound, radiologists can detect about three additional cancers per 1,000 women screened. Hyperechoic breast lesions | Radiology Reference Article - Radiopaedia On ultrasound, a breast cancer tumor is often seen as hypoechoic. T refers to the size of the main, or primary, tumor. DOI: Bjelovic B, et al. Benign conditions such as breast adenosis (numerous and enlarged milk glands), fat necrosis (damage to fatty breast tissue), and radial scars (growths that look like scars when magnified) may look very similar to cancers on a mammogram. Sometimes it can be difficult to tell the difference between mastitis (inflammation of breast tissue) and inflammatory breast cancer, but mastitis often causes symptoms of fever, chills, and body aches. J Cancer. When a nodule appears hypoechoic rather than anechoic, radiologists know it's likely solid and not liquid-filled. Cancerous masses on MRI differ both in how they look and the length of time they appear (kinetics). A doctor may discover a breast lesion during an imaging test, such as a routine mammogram, or an ultrasound that was initially ordered for another reason. This cookie is set by GDPR Cookie Consent plugin. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. However I cannot exclude possibility of Neoplasm and I would suggest a short term follow up examination in 3 months. T1: The tumor is 2 cm or less in diameter. It can help in the search for a subtle, isoechoic mass. Last medically reviewed on June 27, 2022, Multifocal breast cancer is where a person has more than one tumor in one area of their breast. What to know about multifocal breast cancer. Leung A, et al. This is the American ICD-10-CM version of R92.8 - other international versions of ICD-10 R92.8 may differ. 5.4k views Reviewed >2 years ago. Nipple wart (n = 2, 15%): Two patients showed a unilateral soft exogenous neoplasm. Unable to process the form. But only about 5% of thyroid nodules are cancerous. Ultrasound is a useful tool to see if any part of your body has changed from its baseline state. It really comes down to: irregular margins, irregular shape, dark hypoechoic. Architectural Distortion of the Breast : American Journal of Options may include:. A hypoechoic lesion is one that reflects less ultrasonic waves than would normally be expected. A doctor or nurse may also discover a breast lesion during a physical exam. On exam, other changes may be present as well. Tumors form when cells continue growing despite being told by the body to stop. How to Reduce Your Risk of Breast Cancer: 10 Lifestyle Recommendations, a wait-and-see approach, especially in younger females, aspiration to remove fluids inside the lesion, surgical removal in older females, or if diagnostic testing reveals possible signs of cancer, or the results are inconclusive. (2015). All rights reserved. Ultrasonographic features of ductal carcinoma in situ: analysis of 219 It can indicate the presence of a tumor, but many times these masses are benign (noncancerous). Masses that affect organs, blood vessels, and nerves are commonly removed. Hyperechoic. 2. 4. Most lesions found in women consulting a physician are benign. Fat necrosis of the breast is a harmless and usually painless condition. There is a wart on your toe, the doctors says, Ill put some liquid nitrogen on that lesion. They are an abnormal change in a tissue or organ. It makes up less, Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. Solid masses are hypoechoic and can be cancerous. Anechoic masses are often fluid-filled. Tumors and cysts are two distinct entities. Hypoechoic masses that are diagnosed as malignant require more aggressive treatment. View Frank Gaillard's current disclosures, see full revision history and disclosures, shoulder (modified transthoracic supine lateral), acromioclavicular joint (AP weight-bearing view), sternoclavicular joint (anterior oblique views), sternoclavicular joint (serendipity view), foot (weight-bearing medial oblique view), paranasal sinus and facial bone radiography, paranasal sinuses and facial bones (lateral view), transoral parietocanthal view (open mouth Waters view), temporomandibular joint (axiolateral oblique view), cervical spine (flexion and extension views), lumbar spine (flexion and extension views), systematic radiographic technical evaluation (mnemonic), foreign body ingestion series (pediatric), foreign body inhalation series (pediatric), pediatric chest (horizontal beam lateral view), neonatal abdominal radiograph (supine view), pediatric abdomen (lateral decubitus view), pediatric abdomen (supine cross-table lateral view), pediatric abdomen (prone cross-table lateral view), pediatric elbow (horizontal beam AP view), pediatric elbow (horizontal beam lateral view), pediatric forearm (horizontal beam lateral view), pediatric hip (abduction-internal rotation view), iodinated contrast-induced thyrotoxicosis, saline flush during contrast administration, CT angiography of the cerebral arteries (protocol), CT angiography of the circle of Willis (protocol), cardiac CT (prospective high-pitch acquisition), CT transcatheter aortic valve implantation planning (protocol), CT colonography reporting and data system, CT kidneys, ureters and bladder (protocol), CT angiography of the splanchnic vessels (protocol), esophageal/gastro-esophageal junction protocol, absent umbilical arterial end diastolic flow, reversal of umbilical arterial end diastolic flow, monochorionic monoamniotic twin pregnancy, benign and malignant characteristics of breast lesions at ultrasound, differential diagnosis of dilated ducts on breast imaging, musculoskeletal manifestations of rheumatoid arthritis, sonographic features of malignant lymph nodes, ultrasound classification of developmental dysplasia of the hip, ultrasound appearances of liver metastases, generalized increase in hepatic echogenicity, dynamic left ventricular outflow tract obstruction, focus assessed transthoracic echocardiography, arrhythmogenic right ventricular cardiomyopathy, ultrasound-guided biopsy of a peripheral soft tissue mass, ultrasound-guided intravenous cannulation, intensity-modulated radiation therapy (IMRT), stereotactic ablative radiotherapy (SBRT or SABR), sealed source radiation therapy (brachytherapy), selective internal radiation therapy (SIRT), preoperative pulmonary nodule localization, transjugular intrahepatic portosystemic shunt, percutaneous transhepatic cholangiography (PTC), transhepatic biliary drainage - percutaneous, percutaneous endoscopic gastrostomy (PEG), percutaneous nephrostomy salvage and tube exchange, transurethral resection of the prostate (TURP), long head of biceps tendon sheath injection, rotator cuff calcific tendinitis barbotage, subacromial (subdeltoid) bursal injection, spinal interventional procedures (general), transforaminal epidural steroid injection, intravenous cannulation (ultrasound-guided), inferomedial superolateral oblique projection, breast ultrasound features: benign vs malignant, Breast ultrasound features: benign vs malignant, Ultrasound characterisation of breast lesions, Ultrasound characterization of breast lesions, Ultrasound characteristics of benign breast lesions, Ultrasound characteristics of malignant breast lesions, alternate hypo-hyperechoic lines radiating perpendicularly from surface of nodules (if lesion is surrounded by echogenic tissue, hypoechoic strands will be seen; if lesion is surrounded by fat, echogenic strands may be seen), except in certain grade III Invasive ductal carcinomas, small lobulations 1-2 mm on the surface; risk of malignancy rises with increasing numbers, multiple projections from the nodule within or around ducts extending away from the nipple, usually seen in larger tumors, is seen as projection from a nodule which extends radially within or around a duct towards the, in general terms, benign lesions compress with transducer pressure and malignant lesions displace the breast tissue without changing in height; this is the basis for, well circumscribed, hyperechoic tissue: ~100%, gently curving smooth lobulations (<3 in a wider than deep nodule, i.e.

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