Pure Lobular Carcinoma of the Breast Presenting as a Hyperechoic Mass: Incidence and Imaging Characteristics

Jones, Katie N.; Magut, Maureen; Henrichsen, Tara L.; Boughey, Judy C.; Reynolds, Carol; Glazebrook, Katrina N.

doi:10.2214/ajr.12.9742

Cited by 25 publications

(23 citation statements)

References 16 publications

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“…Waterman et al 6 who studied sonographic appearances of 406 invasive breast carcinomas reported that a hyperechoic or isoechoic pattern was more frequent in ILC. Jones et al 7 conducted a retrospective review of 509 ILCs and concluded that 27 (5%) were hyperechoic. The periductal infiltration by ILCs with formation of concentric rings Haematoxylin & Eosin.…”

Section: Invasive Lobular Carcinomamentioning

confidence: 99%

Malignant hyperechoic breast lesions at ultrasound: A pictorial essay

et al. 2016

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SummaryMalignant breast lesions are typically hypoechoic at sonography. However, a small subgroup of hyperechoic malignant breast lesions is encountered in clinical practice. We present a pictorial essay of a number of different hyperechoic breast malignancies with mammographic, sonographic and histopathologic correlation. Suspicious sonographic features in a hyperechoic lesion include inhomogeneity in echogenic pattern, an irregular margin, posterior acoustic shadowing and internal vascularity. A hyperechoic lesion at ultrasound does not discount the need to undertake histological assessment of a mammographically suspicious lesion.

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Section: Invasive Lobular Carcinomamentioning

confidence: 99%

Malignant hyperechoic breast lesions at ultrasound: A pictorial essay

et al. 2016

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“…In addition, an invasive ductal carcinoma in this group and a lymphoma also had a very prominent component of adipose tissue. In previous studies, lobular carcinomas have been associated with a hyperechoic appearance more frequently than ductal carcinomas . In a study by Cawson et al, 21 of 37 lobular carcinomas (57%) were hyperechoic or had a significant hyperechoic component, compared to 7 of 60 (12%) ductal carcinomas.…”

Section: Discussionmentioning

confidence: 92%

“…In a study by Cawson et al, 21 of 37 lobular carcinomas (57%) were hyperechoic or had a significant hyperechoic component, compared to 7 of 60 (12%) ductal carcinomas. Others have reported lower rates of hyperechoic lobular carcinomas (ranging from 1% to 16%), but higher than the average rate of hyperechoic malignancies in the breast (0.4%) . It is more common for lobular carcinomas to lack a desmoplastic response when compared to other types of breast cancer .…”

Section: Discussionmentioning

confidence: 93%

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

et al. 2019

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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

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“…In 66 (13 %) lesions, focal shadowing was seen without a discrete mass. Fourteen (3 %) lesions were isoechoic with respect to surrounding normal adipose tissue without acoustic shadowing [ 19 ] (Fig. 1 ).…”

Section: Histologic Types and Imaging Characteristicsmentioning

confidence: 97%