Correct Answer: D
The ultrasound image reveals a well-defined, anechoic (black), thin-walled fluid collection located in the subcutaneous or parenchymal plane of the breast. This is most consistent with a seroma, particularly in the context of recent breast surgery.
A seroma is a common postsurgical finding, representing a sterile collection of serous fluid that accumulates in the surgical bed. It typically appears:
* Anechoic (or hypoechoic if older)
* Well circumscribed
* Without internal septations or debris
* Lacking hyperemia or surrounding inflammatory changes
This contrasts with:
* A. Carcinoma - typically presents as an irregular, hypoechoic mass with angular margins, internal vascularity, and shadowing.
* B. Blood clot (hematoma) - often appears heterogeneous, with internal echoes and variable echotexture depending on the age of the clot.
* C. Abscess - appears as a complex fluid collection with thick walls, internal debris, septations, and surrounding hyperemia (often with clinical signs of infection).
D: Seroma - Correct. The described anechoic, clean-walled fluid collection is classic for a postoperative seroma.
References:
Mendelson EB, Bohm-Velez M, Berg WA.ACR BI-RADS Atlas: Ultrasound. American College of Radiology; 2013.
Stavros AT. Breast Ultrasound. Lippincott Williams & Wilkins; 2004.
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound, 5th ed. Elsevier; 2017.