Predictors of Malignancy in Hyperechoic Breast Lesions

Nassar, Lara; Issa, Ghada; Farah, Zeina; Zein, Youssef El; Berjawi, Ghina

doi:10.7863/ultra.15.05020

Cited by 9 publications

(10 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…5 lesions were palpable, 3 subjects had a previous history of carcinoma breast, 3 subjects had MRI correlation, 5 had mammography correlation, and vascularity was seen in 6 lesions. These results were in agreement with the results of Adrada B et al [8] in 2013 and Nassar L et al [9] in 2016 where the clinical evaluation of hyperechoic breast lesions showed similar results as the present study. The present study also assessed the sonographic aspects of the hyperechoic malignant lesions, it was seen that vascularity, hypoechoic lesions, shape, and posterior acoustic features were non-significant among benign and malignant hyperechoic lesions, whereas, circumscribed margins were seen in 62.5% (n=5) and non-circumscribed by 37,5% (n=3) study subjects with benign lesions, and by 100% (n=5) subjects with malignant lesions.…”

Section: Discussionsupporting

confidence: 94%

Evaluating the Hyperechoic lesions of breast by ultrasonography: A clinical and radiologic study

Naidu¹,

Rao²,

Raju³

2021

Int. J. Radiol. Diagn. Imaging

View full text Add to dashboard Cite

Background: Benign lesions in the past were thought to be hyperechogenic lesions on ultrasonography. Recently, this conception has been changed where various malignant breast lesions were hyperechogenic on ultrasound and hyperechogenic lesions turned out to be malignant on histopathologic examination. Aim: The present retrospective clinical study was conducted to assess the clinical presentation, frequency, and related imaging finding of hyperechoic malignant breast lesions in cases with core needle biopsies guided ultrasonographically, and also, to assess ultrasonographic features that help in the prediction of the hyperechoic lesion to be malignant. Methods: In a total of 2255 subjects, an ultrasonographically guided core needle biopsy was done for 2168 subjects. The hyperechoic carcinomas were identified among all the assessed cases diagnosed by ultrasonography-guided core needle biopsy was calculated. For malignant lesions, imaging malignancy predictors were identified using 6 ultrasonography images comparison in malignant and high-risk cases. The sonographic findings assessed were orientation, vascularity, shape, posterior acoustic features, margins, and echogenicity. The results were formulated after the statistical evaluation. Results: A total of 2255 ultrasonographically guided core needle biopsy was done for 2168 subjects where 52.01% (n=1173) lesions were benign, 40.97% (n=924) were malignant, and 7% (n=158) were high risk. The study results have shown that in total 2255 lesions assessed, 0.57% (n=13) lesions were hyperechoic in 13 females after analyzing the image. In 924 malignant lesions 0.97% (n=9) lesions were hyperechoic. Circumscribed margins were seen in 62.5% (n=5) and non-circumscribed by 37,5% (n=3) study subjects with benign lesions, and by 100% (n=5) subjects with malignant lesions (p=0.007). For the shape of the lesions, more malignant lesions had irregular and lobular margins 100 (n=5) lesions, whereas, in benign lesions, 87.5 (n=7) had irregular/lobular margins (p=0.002). Conclusion:The present study concludes that hyperechoic breast lesions on ultrasonography have less prevalence of 0.57% (n=13) lesions in the present study. Hence, hyperechoic breast lesions are less encountered on sonography. However, whenever these hyperechoic lesions are seen, the probability of malignancy should not be excluded.

show abstract

Section: Discussionsupporting

confidence: 94%

Evaluating the Hyperechoic lesions of breast by ultrasonography: A clinical and radiologic study

Naidu¹,

Rao²,

Raju³

2021

Int. J. Radiol. Diagn. Imaging

View full text Add to dashboard Cite

show abstract

“…Breast lesions described as hyperechoic are rare, making up only 0.2% to 0.6% of all lesions evaluated by US . Because many of these lesions are considered to be at low risk for malignancy by imaging criteria, fewer than half may undergo biopsy.…”

Section: Discussionmentioning

confidence: 99%

“…Fifty to 65% of lesions described as “hyperechoic” by radiologists and undergoing biopsy also have areas that are not hyperechoic . This pattern is reported as “heterogeneous” in the BI‐RADS lexicon .…”

Section: Discussionmentioning

confidence: 99%

“…This pattern is reported as “heterogeneous” in the BI‐RADS lexicon . Previous studies have used a cutoff of at least 70% hyperechoic areas to define a hyperechoic lesion with a heterogeneous pattern; however, BI‐RADS does not specify the least amount of hyperechogenicity that can be present in such lesions. Clinical assignment of the term “hyperechoic” by the radiologist is therefore based on visual qualitative assessment of the lesions.…”

Section: Discussionmentioning

confidence: 99%

“…In the four studies in which homogeneous lesions were compared to heterogeneous lesions, the incidence of malignancy in homogenous lesions (0%‐18%) has been lower than in heterogeneous lesions (24%‐50%; Table ). Only 3 of 45 (7%) reported hyperechoic malignancies in the literature had a homogeneous pattern (Table ). All three were invasive carcinomas that had noncircumscribed margins, as well as other features concerning for malignancy.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Hyperechoic malignancies of the breast: Underlying pathologic features correlating with this unusual appearance on ultrasound

et al. 2019

View full text Add to dashboard Cite

Hyperechogenicity in the breast on ultrasound (US) is usually regarded as a benign feature with only rare hyperechoic malignancies reported to date. In this study, we evaluated the pathologic findings on core needle biopsy of hyperechoic lesions and investigated the histologic features in malignancies that give rise to an echogenic pattern. A total of 163 core needle biopsies (CNB) were performed for "hyperechoic" or "echogenic" lesions between 1/1/05 and 7/31/17. Lesions were classified based on the proportion of hyperechoic areas identified. We found that all lesions with a homogenous hyperechoic pattern (>90% hyperechoic) were benign (n = 17), regardless of the type of margins. Malignancies were found in 21% (7/34, six invasive carcinomas and one lymphoma) of heterogenous lesions with ≥50% hyperechoic areas (all with noncircumscribed margins) and in 31% of lesions with <50% hyperechoic areas (19/61, 14 invasive carcinomas, two lymphomas, and three metastases), including five with circumscribed margins (one invasive carcinoma, one lymphoma, and three metastases). Two major US patterns were identified in malignant lesions, those with a hypoechoic center and hyperechoic rim, corresponding to a central tumor area with dense stroma and tumor cells infiltrating adipose tissue at the periphery ("rim pattern"), and a second "dispersed pattern" with hyperechoic areas distributed throughout the lesion. Hyperechoic malignancies were found to be comprised of a complex intermixture of elements of differing echogenicity including tumor cells, adipose tissue, and fluid (in tubules, stromal clefts, or blood vessels). Our findings support the importance of radiologists specifying the echogenic pattern of hyperechoic lesions, as heterogenous lesions are associated with a higher risk of malignancy and pathologists should be alert to the associated pathologic findings. K E Y W O R D Sbreast pathology, core needle biopsy, echogenic lesions, hyperechoic lesions, ultrasound

show abstract

Breast Ultrasound for the Evaluation of Benign Breast Disease

Burgess

O’Neal

2019

Curr Radiol Rep

View full text Add to dashboard Cite

Predictors of Malignancy in Hyperechoic Breast Lesions

Abstract: 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.

Cited by 9 publications

References 25 publications

Evaluating the Hyperechoic lesions of breast by ultrasonography: A clinical and radiologic study

Evaluating the Hyperechoic lesions of breast by ultrasonography: A clinical and radiologic study

Hyperechoic malignancies of the breast: Underlying pathologic features correlating with this unusual appearance on ultrasound

Breast Ultrasound for the Evaluation of Benign Breast Disease

Contact Info

Product

Resources

About