Pathologically Proven Hyperechoic Masses of the Breast on Ultrasound: Differentiation of Malignant and Benign Lesions

Abstract

Objective: The aim of this study was to evaluate the frequency of the characteristic sonographic findings of the pathologically confirmed hyperechoic masses on breast ultrasonography, and clinical and sonographic findings in differentiating the malignant from benign hyperechoic masses. Methods: One hundred and ninety hyperechoic masses on breast ultrasonogram of which were pathologically confirmed were retrospectively analyzed. The clinical features were reviewed according to patient’s age, size of mass, and palpability. The sonographic features were reviewed according to the Breast Imaging Reporting and Data System 4th lexicon: margin, orientation, shaped, and posterior acoustic features. The sonographic features of the benign and malignant masses were statistically analyzed using the chisquare test, the Fisher’s exact test, and T-test. Results: The benign masses were 42 cases (79.2%) and the malignant masses were 11 cases (20.8%). Patient age, size of mass, palpability were not significant difference between malignant and benign masses (P=0.684, P=0.377, P=0.746). Mixed hyperechoic, noncircumscribed margin, irregular shape, nonparallel orientation were significantly different for malignant and benign masses (P<0.001, P=0.01, P=0.003, P=0.025). But posterior acoustic features were not statistically different for malignant and benign masses. Conclusion: Malignant masses with hyperechogenicity were more likely than benign masses to have mixed hyperechoic, noncircumscribed margin, irregular shape, nonparallel orientation. Therefore, pathologically confirm should be performed hyperechoic masses with suspicious findings. Key words: Ultrasonography; Hyperechoic; Breast