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Predictors of Malignancy in Hyperechoic Breast Lesions
Author(s) -
Nassar Lara,
Issa Ghada,
Farah Zeina,
El Zein Youssef,
Berjawi Ghina
Publication year - 2016
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/ultra.15.05020
Subject(s) - medicine , malignancy , radiology , breast imaging , breast cancer , bi rads , invasive lobular carcinoma , medical diagnosis , institutional review board , exact test , lesion , mammography , cancer , invasive ductal carcinoma , pathology , surgery
Objectives Hyperechogenicity has been strongly associated with benign breast lesions. Although it is correct in most cases, hyperechogenicity must not always be considered synonymous with benignancy, as hyperechoic breast cancers do occur. The purpose of this study was to review clinical and imaging characteristics of hyperechoic breast lesions, looking for features associated with malignancy. Methods Institutional Review Board approval was granted for this research. A total of 19,417 sonographic examinations were performed between January 2009 and June 2013. Among these, hyperechoic lesions with histologic diagnoses, stability on long‐term followup, or characteristic imaging appearances were included in the study. The patients' clinical charts, mammograms, and sonograms were reviewed. The clinical and imaging features were recorded, and the data was analyzed by the χ 2 test, Fisher exact test, and independent‐samples t test, looking for statistically significant predictors of malignancy. Results Among the 19,417 scans, 42 patients (0.2%) with 44 hyperechoic lesions were identified. Twenty‐six lesions fulfilling the inclusion criteria were included in the study: 5 malignancies (3 invasive ductal carcinomas, 1 invasive lobular carcinoma, and 1 invasive mucinous cancer) and 21 benign lesions. An irregular shape, a nonparallel orientation, and noncircumscribed margins were significantly associated with the risk of malignancy ( P = .002, .02, and .01, respectively). Conclusions A hyperechoic breast lesion must not always be assumed to be benign. Instead, a full sonographic assessment according to the American College of Radiology Breast Imaging Reporting and Data System descriptors is needed for correct characterization and avoidance of misdiagnosis.