Benign findings
– Circumscribed margin +/- thin echogenic capsule
– Oval shape and wider than tall (“parallel” to the skin)
– Isoechoic or hypoechoic compared to surrounding fat
– Up to 3 macrolobulations (no acute angles along outline)
Suspicious findings
– Spiculated, microlobulated/acutely angled, or indistinct margins
– Irregular shape
– Taller than wide (“Antiparallel”)
– Hypoechoic/Anechoic
– Posterior acoustic shadowing or ductal extension
The presence of a single malignant feature despite multiple associated benign features warrants biopsy
(Laronga 2015)