On breast ultrasound, a lesion is described as wider-than-tall, with a circumscribed margin, uniform low-level internal echoes, and posterior acoustic enhancement. The BI-RADS category most appropriate and the likely diagnosis are:
- A BI-RADS 3 — complex cyst
- B BI-RADS 4A — fibroadenoma
- C BI-RADS 2 — simple cyst ✓
- D BI-RADS 2 — fibroadenoma
Correct answer: C. BI-RADS 2 — simple cyst
Explanation
A simple cyst on ultrasound must fulfil three criteria: anechoic interior, circumscribed margins, and posterior acoustic enhancement. It is classified BI-RADS 2 (benign), requiring no biopsy. A complex cyst has internal echoes or a thick wall (BI-RADS 3–4). Fibroadenoma typically shows a solid oval/lobular hypoechoic mass, not anechoic; it may be BI-RADS 3 or 4A.
Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.
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