Table 2.

Differential diagnosis table for complex solid and cystic breast cancers

	MAMMOGRAPHY	ULTRASOUND	MRI
Invasive Ductal Carcinoma (IDC)	Irregularly shaped mass Spiculated margins Pleomorphic microcalcifications in a segmental distribution	Irregularly shaped mass Hypoechoic (occasionally complex mass with solid and cystic components, secondary to necrosis) Not parallel orientation Angular or spiculated margins Posterior acoustic shadowing	Rim enhancement with centripetal filling.
Ductal Carcinoma in-situ (DCIS)	Microcalcifications Architectural distortion	Calcified DCIS: echogenic foci located within a mass or a duct, associated with internal microlobulations, or distributed in a branch pattern. Noncalcified DCIS: hypoechoic mass with microlobulated margins and no posterior acoustic features, or it may have a “pseudomicrocystic” appearance. Less frequently, can present as an intracystic mass.	Non-mass enhancement in a linear or segmental distribution. Clustered ring internal enhancement pattern.
Mucinous Carcinoma	Microlobulated or circumscribed margins	Complex mass with solid and cystic components. Increased vascularity of the solid components. Posterior acoustic enhancement.	T2 hyperintense
Intracystic Papillary Carcinoma (IPC)	Round or oval shaped mass Microlobulated or circumscribed margins Often in the retroareolar region	Complex mass with solid and cystic components.	Enhancement of the cyst walls, septa, and/or mural nodules.