Fig. 28.

A 52-year-old woman had a palpable mass on the right breast. On standard (A) radial and (B) antiradial ultrasonographic images, the mass was cystic with a fluid-debris level (arrows). There was also a question of an intracystic mass (short solid arrow). The patient was then positioned (C) in the right-side decubitus and then (D) the left-side decubitus positions. The fluid-debris level shifted accordingly (arrows), and the intracystic mass persisted (short solid arrow). Ultrasound-guided aspiration was performed, yielding bloody fluid. Core biopsy of the residual mass showed papillary DCIS (which had bled, causing the fluid-debris level). (Courtesy of Wendie A. Berg, MD, PhD, Lutherville, MD.)