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Objetivo: avaliar, por meio de estudo prospectivo, o valor de diferentes características ultra-sonográficas dos nódulos sólidos, na diferenciação de lesões malignas e benignas da mama. Métodos: foram incluídas 142 pacientes do Programa de Mastologia do Departamento de Ginecologia e Obstetrícia da Universidade Federal de Goiás com nódulos sólidos da mama. A ultra-sonografia mamária foi realizada pelo médico estagiário de mastologia, acompanhado do preceptor. As seis características estudadas foram: contornos, ecos internos, ecos posteriores, diferença dos diâmetros, ligamentos de Cooper e halo ecogênico. Cada descrição característica ultra-sonográfica foi analisada estatisticamente e comparada, após a exérese da lesão, com o resultado do exame anatomopatológico. Resultados: dentre as 142 pacientes incluídas no estudo, 90 (63%) tiveram suas lesões ressecadas, com diagnóstico de 77 tumores benignos (86%) e 13 de malignos (14%). Foram significantes no diagnóstico de malignidade as seguintes características ultra-sonográficas: presença de sombra acústica posterior (p=0,0001), contornos irregulares (p=0,0007), ecos internos heterogêneos (p=0,0015) e diâmetro ântero-posterior (AP) maior que o látero-lateral (LL) (p<0,0001). A presença de halo ecogênico no tumor e a visibilização dos ligamentos de Cooper espessados não influenciaram o diagnóstico de malignidade nesse estudo. Conclusão: a ultra-sonografia é um método diagnóstico que pode ajudar na diferenciação de tumores sólidos benignos e malignos. Os contornos irregulares, os ecos internos heterogêneos, a sombra posterior e o diâmetro AP maior que o LL, quando presentes, apresentaram alta correlação com o exame anatomopatológico de câncer. Purpose: to evaluate, in a prospective way, the importance of ultrasound features of solid breast lesions in the differentiation between benign and malignant lumps. Methods: one hundred and forty-two patients with solid breast lesions, from the Department of Gynecology and Obstetrics of the Federal University of Goias (Brazil), were included in the trial. All ultrasound examinations were performed by a training doctor, always supervised by an experienced professional. The characteristics of the lesions studied were: shape, retrotumoral echoes, internal echoes, oriented diameter, halo of bright echoes and Cooper ligaments. Each of the ultrasound features was compared to the results of the histological examination. Results: among the 142 patients included in the trial, 90 (63%) had their lesions excised, and 77 (86%) had pathologic diagnoses of benign tumors and 13 (14%) of malignant tumors. The following characteristics were statistically significant in the diagnosis of the breast cancer (c²): masses with retrotumoral shadowing (p=0.0001), irregular shape (p=0.0007), heterogeneous internal echoes (p=0.0015) and vertically oriented - taller than wide (p<0.0001). The presence of halo of bright echoes anterior to the lump and the presence of wider Cooper ligaments were not related to the correct diagnosis of malignancy in this trial. Conclusion: ultrasound is a diagnostic method that can help physicians between the differentiation of benign and malignant breast lumps. The presence of retrotumoral shadowing, irregular shape, heterogeneous internal echoes and vertical orientation - lesions taller than wide - were related to the pathologic diagnosis of breast malignancies

Estudo Prospectivo das Características Sonográficas no Diagnóstico de Nódulos Sólidos da Mama