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Age: 26

Sex: Female

Indication: Left breast pain

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Case #15


Findings

  • Heterogeneous hypoechoic mass in the subareolar left breast with ill-defined margins, posterior acoustic enhancement, and peripheral hyperemia measuring 2.1 x 4.1 x 4.1 cm
  • Increased echogenicity of the surrounding breast tissue and overlying skin thickening


Diagnosis

Breast abscess

Sample Report

Heterogeneous hypoechoic mass in the subareolar left breast with ill-defined margins, posterior acoustic enhancement, and peripheral hyperemia measuring 2.1 x 4.1 x 4.1 cm, which is concerning for a left breast abscess and surrounding mastitis/cellulitis. Recommend surgical evaluation and consideration of followup breast ultrasound if there is concern for incomplete resolution following treatment.


Discussion

  • Abscesses commonly have heterogeneous internal echogenicity but should not have internal blood flow on Doppler analysis
  • Watch out for inflammatory carcinoma as a potential abscess/mastitis mimic – this should be excluded by biopsy in patients who do not respond as expected to antibiotics
  • No matter which BI-RADS category you choose to assign these patients, they need clinical followup at minimum to ensure resolution



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