Characterization of Solid Breast Masses

Abstract

Objective. The purpose of this study was to determine the reliability of sonographic American College of Radiology Breast Imaging Reporting And Data System (BI-RADS) classification in differentiating benign from malignant breast masses. Methods. One hundred seventy-eight breast masses studied by sonography with a known diagnosis were reviewed. All lesions were classified according to the sonographic BI-RADS lexicon. Pathologic results were compared with sonographic features. Sensitivity, specificity, accuracy, and positive predictive value (PPV) and negative predictive value (NPV) for the sonographic BI-RADS lexicon were calculated. Results. Twenty-six cases were assigned to class 3, 73 to class 4, and 79 to class 5. Pathologic results revealed 105 malignant and 73 benign lesions. The sonographic BI-RADS lexicon showed 71.3% accuracy, 98.1% sensitivity, 32.9% specificity, 67.8% PPV, and 92.3% NPV. The NPV for class 3 was 92.3%. The PPVs for classes 4 and 5 were 46.6% and 87.3%. Typical signs of malignancy were irregular shape, antiparallel orientation, noncircumscribed margin, echogenic halo, and decreased sound transmission. Typical signs of benignity were oval shape and circumscribed margin. Conclusions. The sonographic BI-RADS lexicon is an important system for describing and classifying breast lesions.

Undiagnosed Breast Cancer: Features at Supplemental Screening US

“…In our study, the most common reason for undiagnosed cancer was misinterpretation (49% [28 of 57 actionable findings]), and a noncircumscribed margin was more frequently found than in underthreshold findings (74% [42 of 57 findings] vs 40% [six of 15 findings], P = .028). Although the noncircumscribed margin is already well known for its high positive predictive value (range, 54%-82%) (20,21), lesions with this finding had not initially been US image obtained 12 months later shows that the mass (arrow) has enlarged, with a more irregular shape. This mass was confirmed as a 0.6-cm, low-grade ductal carcinoma in situ.…”

Breast carcinomas: variations in sonoelastographic appearance

“…Other data that should be assessed include shape, margins, orientation, echotexture, posterior acoustic features, relationship with surrounding tissue, and vascularization 12. However, some carcinomas can present as probably benign lesions on ultrasonography and are generally classified as BI-RADS ® (Breast Imaging and Reporting Data System) category 3, leading to false-negative results 13,14. These lesions are usually related to specific tumor types, such as medullary, mucinous, and papillary carcinomas.…”

Role of B Mode in Evaluating Malignant Breast Masses

“…The Pearson Chi-Square test showed a p-value 0.000 which indicated that the test between the variables was statistically significant. According to Constantini the shape of the nodule is the most reliable criterion for differentiating between benign and malignant breast nodules 13 . While benign breast nodules are mostly round or oval, malignant nodules are found to be irregular in shape.…”