Fig. 3.

Mucinous carcinoma in right breast and invasive ductal carcinoma in left breast in 62-year-old woman.

A. HHUS shows 30 mm indistinct irregular hypoechoic mass (arrows) with combined posterior features in left breast. Orientation of mass is parallel and final assessment is BI-RADS category 4. B, C, D. Three readers detected same mass (arrows) on three dimensional AWUS multiplanar images. This is representative case that showed fair interobserver agreement for margin. Three readers agreed on shape (irregular), orientation (parallel), echogenicity (hypoechoic) and BI-RADS category (category 4). Readers did not agree on margin and posterior features. Descriptive terms that were used were indistinct, angular and spiculated for margin and shadowing and were combined for posterior features. AWUS = automatied whole breast ultrasound, BI-RADS = breast imaging reporting and data system, HHUS = hand held ultrasound