55-year-old female. Patient had a suspected intraductal mass with associated ductal dilatation in the right breast within or immediately behind the nipple. MR directed ultrasound was recommended for further evaluation. A targeted right breast ultrasound was performed for the area of concern on MRI. In the superolateral retroareolar region, there is a 1.4 x 0.6 x 1.1 cm circumscribed parallel hypoechoic mass without significant internal vascularity. A dilated duct leads up to this mass, which corresponds to the enhancing intraductal lesion seen on MRI. The mass is inseparable from and likely within the nipple itself.
The previously seen MRI intraductal mass has a sonographic correlate of a 1.4 cm circumscribed hypoechoic mass in the nipple, which may be a papilloma but is nonspecific. Further evaluation with an ultrasound guided biopsy is recommended.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration.