Hypoechoic area on breast ultrasound came back as benign breast tissue with lactational changes. Can a mass come back as this? I'm worried. I'm nursing

Breast mass. It will be important to follow up with your physician to ensure that the images and the pathology report are concordant (that they agree) and, probably, get a follow-up ultrasound to ensure stability or resolution of the mass.
Depends. Yes it could. It depends on the size the radiologist measured it as and if that correlates with what the pathologist saw under the microscope.
Yes. Beast feeding women can have exaxctly that pathology. I'm a little surprised you even had a biopsy given your age and the ultrasound finding with you breast feeding.

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