Stavros et al identified benign and malignant solid lesions in the female breast based on the ultrasonographic findings. This can help determine which patients require more aggressive followup and management. The authors are from Radiology Imaging Associates in Englewood, Colorado.
|
Findings
|
Benign
|
Indeterminate
|
Malignant
|
|
lobulations
|
gentle bi- or trilobulations
|
|
microlobulation
|
|
echogenicity
|
intense hyper
|
mild hypo or iso
|
marked hypo
|
|
|
|
|
spiculations
|
|
|
|
|
shadowing
|
|
shape
|
ellipsoid
|
|
angular margins, taller than wide
|
|
capsule
|
thin, echogenic pseudocapsule
|
|
|
|
calcifications
|
|
|
punctate
|
|
patterns
|
|
|
duct extension, or branch pattern
|
Benign pattern - absence of all malignant features PLUS one of the following:
(1) intense and uniform hyperechogenicity
(2) ellipsoid shape with a thin echogenic capsule
(3) gentle bi/tri lobulations with a thin echogenic capsule
Features associated with malignant tumors:
(1) Angular margin: angular junction (acute, obtuse or right angle) between the relatively hypoechoic or isoechoic central portion of a solid nodule and the surrounding tissue.
(2) Branch pattern: multiple projections from the nodule within or around ducts extending away from the nipple.
(3) Duct extension: a projection from the nodule that extends radially within or around a duct and courses towards the nipple.
(4) Hypoechoic: considered "marked" when a nodule is very black compared with surrounding isoechoic fat.
(5) Microlobulation: presence of several small (1-2 mm) lobulations on the surface of a solid breast nodule.
(6) Punctate calcifications: sonographically visible within solid nodules.
(7) Shadowing: refers to an any area with relatively less through transmission of sound than is present in surrounding tissues.
(8) Spiculations: alternating hyperechoic and hypoechoic straight lines that radiate from the surface of the solid nodule. If the lesion is surrounded by fibrous tissue, then only the hypoechoic lines may be visible. If the lesion is surrounded by fat, then only the hyperechoic lines may be seen.
(9) Taller than wide: a part or all of nodule is greater in the anterior-posterior dimension than in either the sagittal or transverse dimension.
