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KMID : 1114620070040020149
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Journal of the Korean Society for Breast Screening
2007 Volume.4 No. 2 p.149 ~ p.153
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Sonographic Differentiation of Complex Cystic Mass of the Breast
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Jang Mi-Jung
Cho Nariya
Park Jeong-Seon
Seong Min-Hyun
Chung Hye-Kyung
Moon Woo-Kyung
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Abstract
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Purpose: To describe which US findings can help to differentiate between nonspecific benign disease, abscess, benign tumor and malignant tumor of the complex cystic breast mass.
Materials and Methods: Retrospective review of 979 lesions sampled with sonographically guided core biopsies, between January 2002 and February 2004, yielded 43(0.4%) complex cystic masses. The shape, margin, proportion, inner margin and echo pattern of internal echogenic component were blindly analyzed by two radiologists in consensus. The sonographic findings and pathologic results were assessed for each case.
Results: Fifteen benign tumors, 5 intraductal papillary cancers, 3 invasive cancers, 17 nonspecific benign diseases, 5 abscesses were included. All 3 invasive papillary carcinomas had irregular shape (3/3, 100%) and indistinct (2/3, 67%) or angular (1/3, 33%) margin. Oval shape was seen in 53% of fibrocystic change and 60% of abscess. Proportion of echogenic component was more common in neoplastic disease than in nonneoplastic benign disease (96% [22 of 23] vs. 55% [12 of 22], p = 0.002) and convex or microlobulated inner margin was more common in neoplastic disease than in nonneoplastic benign disease papillary neoplasm (87% [20 of 23] vs. 18% [4 of 22], p < 0.001). Echogenic debris in cystic component was seen in 60% of abscess.
Conclusion: Of the complex cystic breast masses, 18% were proved to be malignant, which is appropriate for category 4a lesion. Higher proportion of internal echogenic solid component, convex or microlobulated inner margin of the solid component is suggestive of neoplastic lesion.
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KEYWORD
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Breast neoplams, Breast radiography, Breast US
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