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)