Cystic lesions of the breast are an everyday encounter in the symptomatic breast clinic. While the vast majority of cystic lesions are benign, it is important to be aware of the imaging manifestations that indicate a sinister pathology and the pitfalls of biopsy in a complex cystic lesion which make the diagnosis challenging. We present a case of cystic Grade 3 breast cancer and highlight the imaging characteristics and clinicoradiological concordance that achieved the correct diagnosis.
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