Differential Diagnosis for Left Breast Lesion
- Single most likely diagnosis
- Fibroadenoma: This is a common benign breast tumor, especially in younger women. The description of the lesion as nearly isoechoic, heterogeneous, and lacking increased color flow is consistent with a fibroadenoma. The size and location of the lesion also support this diagnosis.
- Other Likely diagnoses
- Cyst: Although the lesion is described as solid, some breast cysts can appear heterogeneous and isoechoic on ultrasound. However, the lack of increased color flow and the patient's palpation of a nodule make this less likely.
- Fibrocystic change: This is a common condition characterized by lumpy or rope-like breast tissue. While it can cause palpable nodules, the ultrasound findings in this case are more suggestive of a discrete lesion.
- Hamartoma: A benign breast tumor that can appear as a heterogeneous, isoechoic lesion on ultrasound. However, hamartomas are less common than fibroadenomas.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Phyllodes tumor: Although rare, phyllodes tumors can appear similar to fibroadenomas on ultrasound. They can be benign, borderline, or malignant, and it's essential to consider this diagnosis to avoid missing a potentially malignant lesion.
- Breast cancer: While the ultrasound features are benign, it's crucial to remember that some breast cancers can appear isoechoic and heterogeneous. The lack of increased color flow and the BI-RADS 3 classification suggest a low suspicion for malignancy, but it's essential to follow up as recommended to ensure the lesion does not change over time.
- Rare diagnoses
- Lipoma: A benign tumor composed of fat tissue, which can appear as a heterogeneous, isoechoic lesion on ultrasound. However, lipomas are less common in the breast than in other parts of the body.
- Pseudoangiomatous stromal hyperplasia (PASH): A rare benign breast lesion that can appear as a heterogeneous, isoechoic mass on ultrasound. PASH is often associated with a palpable abnormality and can be difficult to distinguish from other breast lesions.