Can breast ultrasound differentiate cystic from solid masses?

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Ultrasound distinguishes cystic from solid masses by evaluating how the lesion stores and transmits sound. A simple cyst appears anechoic, meaning it’s completely dark, with no internal echoes, and it shows posterior acoustic enhancement because fluid transmits sound easily. It also has a thin, well-defined wall. A solid mass contains tissue with internal echoes, may be hypoechoic or heterogeneous, and often has more defined or irregular margins; color Doppler can reveal internal vascularity in many solid lesions. Complex cystic lesions can show both fluid and solid components, such as septations or debris, which require closer assessment. Because these characteristic features allow clear differentiation in most cases, breast ultrasound can indeed differentiate cystic from solid masses.