Case 4 Answer continued
Ultrasound will only help in that it may allow you to perform a core needle biopsy with ultrasound-guidance. A benign sonographic appearance would not dissuade you from recommending biopsy, because the lesion is suspicious mammographically.
This mass is predominantly hypoechoic with irregular margins and marked posterior acoustic shadowing. Doppler also shows arterial blood flow within it. All of these findings should further convince you that this mass is malignant. Again, if there were none of these findings, you would still recommend biopsy, but the probability that it would yield cancer would be somewhat lower.