The ultrasound assesses tissues in terms of the amount of echo the tissues transmit. Hypoechoic means that the lesion or abnormality has increased density compared to the surrounding tissues. Hypoechoic lesions are mostly benign lesions like fibrocystic disease, or breast cysts. However, there are a minority that may harbor malignancy and I guess this is why your doctor is requesting for a biopsy procedure, just to be sure.
In addition, lesions that are well circumscribed and circular are likewise more likely to be benign in nature.
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