Case 41 Answer 2

BI-RADS 4, Suspicious. This mass has indistinct mammographic margins and solid on ultrasound, and thus is suspicious. In order to be "Probably Benign," a mass must be circumscribed on spot mags and be benign-appearing sonographically. This is not a classic spiculated mass, and still might be benign, so BI-RADS 5 is not appropriate.

Take a look at the sonographic appearance again.

The mass has hypo- and hyper-echoic areas.  What do you think of the hyperechoic portion?

• Likely fat-containing
• Likely contains calcifications
• Mixed echogenicity masses are more likely benign
• I have no earthly idea