Non-mass-like lesions on breast ultrasound: classification and correlation with histology

Wang, Zhi Li; Li, Nan; Li, Min; Wan, Wen

doi:10.1007/s11547-014-0493-x

Cited by 47 publications

(54 citation statements)

References 13 publications

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“…The correct kjronline.org that the retraction phenomenon, hyper-or hypoechoic rim, skipping sign, and white wall sign of the coronal plane were useful in distinguishing benign from malignant breast lesions. In this study, the incidence of NMLs was much lower than that of masses in consecutive women (18,19,21,23), with a rate of approximately 1:5 (80:377). Additionally, the coronal ABUS image features were correlated with the clinical factors according to lesion type.…”

Section: Diagnostic Value Of Coronal Featuresmentioning

confidence: 51%

“…In contrast, a NML refers to a hypoechoic area lacking a conspicuous margin or shape and can be defined as a nonspace occupying lesion (17). Previous studies (18)(19)(20)(21)(22)(23) have reported some features that may aid in the identification of malignant NMLs, such as palpability, architectural distortion, and calcification. However, whether the coronal features can help to evaluate NMLs has not been discussed.…”

Section: Definition Of Image Type and Coronal Featuresmentioning

confidence: 99%

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Automated Breast Ultrasound: Interobserver Agreement, Diagnostic Value, and Associated Clinical Factors of Coronal-Plane Image Features

Tang

Xiang

et al. 2020

Korean J Radiol

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Objective: To evaluate the interobserver agreement, diagnostic value, and associated clinical factors of automated breast ultrasound (ABUS) coronal features in differentiating breast lesions. Materials and Methods: This study enrolled 457 pathologically confirmed lesions in 387 female (age, 46.4 ± 10.3 years), including 377 masses and 80 non-mass lesions (NMLs). The unique coronal features, including retraction phenomenon, hyper-or hypoechoic rim (continuous or discontinuous), skipping sign, and white wall sign, were defined and recorded. The interobserver agreement on image type and coronal features was evaluated. Furthermore, clinical factors, including the lesion size, distance to the nipple or skin, palpability, and the histological grade were analyzed. Results: Among the 457 lesions, 296 were malignant and 161 were benign. The overall interobserver agreement for image type and all coronal features was moderate to good. For masses, the retraction phenomenon was significantly associated with malignancies (p < 0.001) and more frequently presented in small and superficial invasive carcinomas with a low histological grade (p = 0.027, 0.002, and < 0.001, respectively). Furthermore, continuous hyper-or hypoechoic rims were predictive of benign masses (p < 0.001), whereas discontinuous rims were predictive of malignancies (p < 0.001). A hyperechoic rim was more commonly detected in masses more distant from the nipple (p = 0.027), and a hypoechoic rim was more frequently found in large superficial masses (p < 0.001 for both). For NMLs, the skipping sign was a predictor of malignancies (p = 0.040). Conclusion: The coronal plane of ABUS may provide useful diagnostic value for breast lesions.

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Section: Diagnostic Value Of Coronal Featuresmentioning

confidence: 51%

Section: Definition Of Image Type and Coronal Featuresmentioning

confidence: 99%

Automated Breast Ultrasound: Interobserver Agreement, Diagnostic Value, and Associated Clinical Factors of Coronal-Plane Image Features

Tang

Xiang

et al. 2020

Korean J Radiol

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“…The reason for the difference might be that diagnostic criteria for non-mass-like lesions have not yet been established, standardized analysis of non-mass-like lesions cannot be performed, and the diagnosis of non-masslike lesions is susceptible to the subjectivity of sonographers. In fact, not only DCIS lesions, but also other malignant lesions and benign lesions can present as non-masslike lesions, such as infiltrating ductal carcinoma (IDC), lymphatic metastatic poorly differentiated adenocarcinoma, adenocarcinoma, acute lymphatic leukaemia, infiltrating lobular carcinoma (ILC), adenosis, intraductal papilloma and plasma cell mastitis (21,27). According to the results of previous studies, mottled and geographic patterns, architectural distortion, posterior acoustic shadowing, microcalcifications, older (postmenopausal) patient age, and a larger lesion size were more frequently associated with malignant non-mass-like lesions than benign non-masslike lesions (28)(29)(30)(31)(32).…”

Section: Discussionmentioning

confidence: 99%

Ultrasonographic features of ductal carcinoma in situ: analysis of 219 lesions

Wang

et al. 2020

Gland Surg

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Background: The purpose of this paper is to clarify the ultrasonographic features and classification of ductal carcinoma in situ (DCIS), and to evaluate the ability of ultrasonography in the prediction of DCIS. Methods: The clinical data, gray-scale ultrasound images and pathological results of 219 DCIS lesions that detected in 203 consecutive patients who underwent ultrasonography and surgery in our hospital from January 1, 2014 to December 31, 2019 were collected retrospectively. Ultrasonographic features and classification of DCIS were summarized, and the accuracy of ultrasonography in predicting different ultrasonographic findings of DCIS were compared. Results: Among the 219 DCIS lesions, 91 (41.6%) presented as mass-like lesions and 128 (58.4%) were non-mass-like lesions. For the 91 mass-like DCIS lesions, 79 were hypoechoic solid masses, 12 were cysticsolid structures. For the 128 non-mass-like DCIS lesions, 114 were hypoechoic areas, 10 were ductal dilatation accompanied with intraductal solid components, and 4 were multiple punctate echogenic foci only. The diagnostic accuracy of ultrasound for the 219 DCIS lesions was 81.7% (179/219). The diagnostic accuracy of mass-like DCIS lesions was 90.1% (82/91), which was significantly higher than that in nonmass-like DCIS lesions [75.8% (97/128), P=0.007]. The diagnostic accuracy of hypoechoic solid masses was significantly higher than those of the other ultrasonographic findings (P=0.002). Ducts abnormalities were detected in 45 (20.5%) lesions and punctate echogenic foci in 134 (61.2%) lesions. The diagnostic accuracy of lesions with ducts abnormalities was 93.3% (42/45), which was significantly higher than that in lesions without ducts abnormalities [78.7% (137/174), P=0.024]. The diagnostic accuracy of lesions with punctate echogenic foci was 92.5% (124/134), which was significantly higher than that in lesions without punctate echogenic foci [64.7% (55/85), P=0.000].Conclusions: DCIS lesions can effectively be recognized as mass-like lesions and non-mass-like lesions by ultrasound. Hypoechoic areas and hypoechoic solid masses were the most common ultrasonographic features of DCIS. Ducts abnormalities and punctate echogenic foci were helpful for the diagnosis of DCIS.

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“…Recently, studies based on B-mode, color Doppler ow imaging (CDFI), and strain or shear-wave elastography to distinguish benign from malignant NMLs have demonstrated their diagnostic performance. Similar to non-mass-like enhancement on breast MRI, with the enhanced image quality of high-resolution ultrasonography and widespread use of bilateral whole-breast examinations, it is possible to detect the hypoechoic regions (NMLs) that do not meet criteria for space-occupying lesions de ned by BI-RADS [12,13]. NMLs re ect a wide range of breast lesions, including benign, high-risk, and malignant lesions.…”

Section: Introductionmentioning

confidence: 99%

Comparative study of multiple breast cancer screening methods in the evaluation of breast non-mass-like lesions

Zhang

Cai

Chen

et al. 2021

Preprint

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Objective: To compare multiple breast cancer screening methods for evaluating breast non-mass-like lesions (NMLs) and to investigate the best screening method for breast non-mass-like lesions (NMLs). Methods: This retrospective study examined 253 patients aged 24 to 68 years who were diagnosed with breast NMLs from April 2017 to December 2019. All lesions were evaluated by MG, HHUS, and ABUS to determine BI-RADS classification, underwent pathological examination within six months or at least 2 years of follow-up. The sensitivity, specificity, accuracy, positive predictive values (PPV), and negative predictive values (NPV) of MG, HHUS, and ABUS features in the prediction of malignancy were compared. Independent risk factors for malignancy were assessed using non-conditional logistic regression. Results: MG, HHUS, and ABUS findings significantly differed between benign and malignant breast NML, including internal echo, hyperechoic spot, peripheral blood flow, internal blood flow, catheter change, peripheral change, coronal features of ABUS, and structural distortion, asymmetry, and calcification in MG. ABUS was superior to MG and HHUS in sensitivity, specificity, PPV, NPV, as well as in evaluating the necessity of biopsy and accuracy in identifying malignancy. MG was superior to HHUS in specificity, PPV, and accuracy in evaluating the need for biopsy. HHUS was distinctly superior to MG in sensitivity and NPV in determining malignancy; however, specificity, PPV, and accuracy were similar. Moreover, internal blood flow, calcification, and coronal plane feature were independent risk factors in distinguishing benign and malignant lesions. Conclusions: ABUS was superior to HHUS and MG in evaluating the need for biopsy and differentiating benign and malignant in breast NMLs. Compared to each other, HHUS and MG had their own relative advantages. Internal blood flow, calcification, and coronal plane feature were independent risk factors in identifying benign and malignant lesions.

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Non-mass-like lesions on breast ultrasound: classification and correlation with histology

Cited by 47 publications

References 13 publications

Automated Breast Ultrasound: Interobserver Agreement, Diagnostic Value, and Associated Clinical Factors of Coronal-Plane Image Features

Automated Breast Ultrasound: Interobserver Agreement, Diagnostic Value, and Associated Clinical Factors of Coronal-Plane Image Features

Ultrasonographic features of ductal carcinoma in situ: analysis of 219 lesions

Comparative study of multiple breast cancer screening methods in the evaluation of breast non-mass-like lesions

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