Differential Diagnosis for Right Breast Lump
- Single most likely diagnosis
- Invasive ductal carcinoma: This is the most likely diagnosis given the biopsy results from 4/15/25, which confirmed invasive ductal carcinoma. The ultrasound findings of a macrolobulated mass with marked increased vascularity and the BI-RADS 4 suspicious classification also support this diagnosis.
- Other Likely diagnoses
- Fibroadenoma: Although less likely given the biopsy results, fibroadenomas can present as macrolobulated masses and are common in women. However, the increased vascularity and BI-RADS 4 classification make this less likely.
- Phyllodes tumor: These tumors can also present as macrolobulated masses and can have increased vascularity. However, they are less common than invasive ductal carcinoma and fibroadenoma.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Inflammatory breast cancer: Although the skin surfaces are reported as within normal limits, inflammatory breast cancer can present with subtle skin changes and is a deadly diagnosis if missed. The increased vascularity and rapid growth of the mass could be indicative of this aggressive cancer.
- Metastasis to the breast: Although rare, metastasis to the breast from other primary cancers can occur and would be a critical diagnosis to miss.
- Rare diagnoses
- Pseudoangiomatous stromal hyperplasia (PASH): A rare benign tumor that can present as a macrolobulated mass, but is less likely given the biopsy results and clinical presentation.
- Hamartoma: A rare benign tumor that can present as a macrolobulated mass, but is less likely given the biopsy results and clinical presentation.