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Support the channel on Patreon: patreon.com/drsamsimaginglibrary Breast Ultrasound Normal Vs Invasive Ductal Carcinoma (IDC) | BI-RADS 4/5 Masses | Breast Cancer USG BI-RADS Category 4: Suspicious Abnormality Findings are suspicious for malignancy, but they do not have the classic features of cancer. The likelihood of malignancy is greater than 2% but less than 95%. 4A (Low suspicion): Likelihood of malignancy is 2%-10%. 4B (Moderate suspicion): Likelihood of malignancy is 10%-50%. 4C (High suspicion): Likelihood of malignancy is 50%-95%. BI-RADS Category 5: Highly Suspicious for Malignancy Findings have a very high probability of malignancy, with the likelihood of cancer being greater than 95%. Invasive Ductal Carcinoma Hypoechoic/heterogeneous mass Shape: Irregular or spiculated Taller-than-wide orientation: Vertical dimension exceeds the horizontal. Heterogeneous: The internal structure may show mixed echotexture due to necrosis, fibrosis, or tumor heterogeneity. Shadowing: Posterior acoustic shadowing is common in early stages (grade 1) due to the desmoplastic reaction (dense fibrous tissue formation) with IDC. BI-RADS 5: Biopsy is strongly recommended Increased vascularity: Color Doppler ultrasound may reveal increased blood flow within or around the lesion, indicating angiogenesis. Microcalcifications: Appear as hyperechoic dots in the mass.