Differential Diagnosis for Female Breast Ultrasound Findings
Single Most Likely Diagnosis
- Fibrocystic Changes: This is the most common cause of multiple cystic masses in the breast, especially when bilateral and symmetric. Fibrocystic changes are a benign condition characterized by the presence of cysts, fibrosis, and sometimes epithelial hyperplasia, which can cause lumps, tenderness, and a range of imaging appearances.
Other Likely Diagnoses
- Simple Cysts: These are benign fluid-filled structures that can be single or multiple and are very common in the female breast. They are usually well-defined, anechoic, and have a thin wall on ultrasound.
- Breast Adenosis: This condition involves an overgrowth of the lobules in the breast tissue, which can sometimes appear as multiple cystic masses on ultrasound. It is a benign condition but can increase the risk of breast cancer.
- Intraductal Papilloma: While typically presenting as a solitary lesion, multiple intraductal papillomas can occur and may appear as cystic masses, especially if they contain fluid-filled components.
Do Not Miss Diagnoses
- Metastatic Disease to the Breast: Although rare, metastases from other primary cancers (like lymphoma, melanoma, or ovarian cancer) can present as multiple cystic masses in the breast. This diagnosis is critical to consider due to its implications for treatment and prognosis.
- Inflammatory Breast Cancer: This aggressive form of breast cancer can cause diffuse skin thickening and may mimic benign conditions like mastitis. While less likely to present as discrete cystic masses, it's a diagnosis that cannot be missed due to its poor prognosis.
- Lymphoma Involving the Breast: Primary or secondary lymphoma of the breast can present with a variety of imaging findings, including cystic masses, and is crucial to diagnose accurately due to its distinct treatment approach.
Rare Diagnoses
- Hemangiomas: These are benign vascular tumors that can appear as cystic masses on ultrasound due to their fluid-filled components. They are rare in the breast.
- Phyllodes Tumor: Although more commonly presenting as a solid mass, phyllodes tumors can have cystic components. They are rare and can be benign, borderline, or malignant.
- Breast Abscesses: While typically associated with infection and mastitis, multiple abscesses could theoretically present as cystic masses. However, clinical correlation would typically reveal signs of infection.