Sonographic features of histopathologically benign solid breast lesions that have been classified as BI‐RADS 4 on sonography

Taşkın, Füsun; Köseoğlu, Kutsi; Özbaş, Serdar; Erkuş, Muhan; Karaman, Can Zafer

doi:10.1002/jcu.21923

Cited by 15 publications

(13 citation statements)

References 14 publications

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“…In general, Category 4 lesions require tissue sampling [49]. Previous study reported that heterogeneity, partially indistinct margin, and microlobulation are the most frequent suspicious findings leading to classifying a benign lesion as BI-RADS 4 [50]. If clinicians rely only on 2D ultrasound, excessive biopsies may be performed, consequently eliciting undesirable anxiousness in patients.…”

Section: Discussionmentioning

confidence: 99%

Breast Contrast-Enhanced Ultrasound: Is a Scoring System Feasible? ----A Preliminary Study in China

Xiao

Yang

et al. 2014

PLoS ONE

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ObjectivesAlthough many studies about breast contrast-enhanced ultrasound had been conducted, clear diagnostic criteria for evaluating enhancement patterns are still lacking. This study aims to identify significant indicators for breast contrast-enhanced ultrasound and to establish an initial scoring system.Materials and MethodsTotally 839 patients were included in the study. This study was divided into two parts. 364 patients were included in part 1 while 475 in part 2. Conventional ultrasound and contrast-enhanced ultrasound were used to examine each lesion. Only the cases in part 2 were also examined by elastography. In part 1, Logistic regression analysis was performed to predict significant variables. A 5-point scoring system was developed based on the results. In part 2, the scoring system was used to evaluate all the breast lesions. To evaluate the diagnostic efficacy of the new scoring system, it was compared with the system established for elastography and conventional ultrasound (BI-RADS).ResultsThree independent variables, namely, lesion scope, margin, and shape were selected in the final step of the logistic regression analysis in part 1. In part 2, the area under the ROC (receiver operating characteristic) curve for the contrast-enhanced scoring system was 0.912. The difference in the diagnostic capabilities of the contrast-enhanced scoring system and elastography was not statistically significant (P = 0.17). The difference in the diagnostic capabilities of the contrast-enhanced scoring system and BI-RADS was statistically significant (P<0.001).ConclusionsThe contrast-enhanced patterns of benign and malignant breast tumors are different. The application of a 5-point scoring system for contrast-enhanced ultrasound is clinically promising.

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Section: Discussionmentioning

confidence: 99%

Breast Contrast-Enhanced Ultrasound: Is a Scoring System Feasible? ----A Preliminary Study in China

Xiao

Yang

et al. 2014

PLoS ONE

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“…EIC of the breast typically appears as a smooth, round nodule, the nature of which cannot be detected through this method. Ultrasonographic imaging consistently achieved an accurate diagnosis (1,2,(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)22,23,25,26), whilst mammography achieved accuracy in 79% of the reported cases (6)(7)(8)(9)(10)(11)(12)(15)(16)(17)(21)(22)(23)(24)(25)(26)(27). Magnetic resonance imaging was used in only 2 cases (16,25), but it was also observed to consistently identify EIC of the breast accurately.…”

Section: Discussionmentioning

confidence: 99%

“…Magnetic resonance imaging was used in only 2 cases (16,25), but it was also observed to consistently identify EIC of the breast accurately. FNAC (2,8,(16)(17)(18)(19)(25)(26)(27) and FNAB (1,2,7,8,14,15,18,22,23,25) may also aid the diagnosis, but these methods are less reliable when compared to ultrasonographic imaging. The present literature review demonstrated that ultrasonographic imaging is the diagnostic tool of choice to achieve the accurate characterization of EIC.…”

Section: Discussionmentioning

confidence: 99%

Epidermal inclusion cyst of the breast: A literature review

et al. 2015

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Abstract. An epidermal inclusion cyst (EIC) of the breast is a rare, benign condition that may potentially be malignant. The present study conducted a systematic review of the literature in order to identify pathological hypotheses, clinical characteristics, and diagnostic and treatment options. A search for relevant studies was conducted through the Scopus, Embase and Medline databases during September 2014. The search term employed was ῾epidermal inclusion cyst breast᾽. Studies were selected if they contained adequate information regarding symptoms at presentation, diagnostic tools, pathology, characteristics, type of procedure performed and follow-up routines. A total of 35 papers describing 91 patients affected by EIC of the breast were identified. Following this, a total of 82 patients, including an additional case supplied from the present study, were selected for further analysis. EIC of the breast typically occurs during the fifth decade of life. A palpable mass of the breast was present in 65 (79%) patients. Ultrasonographic imaging was consistently utilized as a diagnostic tool in all the cases analyzed, whereas fine-needle aspiration cytology was used in 70% of the cases and mammography in 65%. No tumor recurrence was reported at a mean follow-up time of 53 months. The present study demonstrated that elliptical excision is the preferred treatment for EIC of the breast, with pathological analysis required to exclude malignancy.

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“…It has been widely used for the BI-RADS classification of breast lesions in the clinic. However, the utility of ultrasound for breast lesions has been varied for some types of lesions, with a lack of specificity for some, or with overlap of benign and malignant signals [14] . Patients with mammary intraductal papillomas typically present with nipple discharge and lumps in the cancer area, which are characterized by catheter expansion and a hypoechoic lesions upon ultrasound examination.…”

Section: Discussionmentioning

confidence: 99%

Comparison of 99mTc-MIBI scintigraphy, ultrasound, and mammography for the diagnosis of BI-RADS 4 category lesions

Liu

Zhan

Sun

2020

Preprint

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Background : We sought to determine the diagnostic efficacy of Breast-specific gamma imaging (BSGI) in Chinese women with BI-RADS 4 category lesions and to compare this efficacy to that of ultrasound/mammography. Methods : We retrospectively assessed 177 women who had undergone BSGI of BI-RADS 4 category lesions detected via ultrasound and/or mammography. Results: Of the 177 cases, 117 (66.1%) were malignant lesions and 60 (33.9%) were benign. The sensitivity, specificity, positive, and negative predictive values of BSGI were 94.9% (111/117), 78.3% (47/60), 89.5% (111/124), and 88.7% (47/53), respectively. For mammography, the specificity and positive predictive values were 48.3% (29/60) and 77.5% (107/138), while for ultrasound they were 53.3% (32/60) and 79.6% (109/137). The sensitivity and specificity of BSGI for the detection lesions ≤1 cm were 90.9% (10/11) and 88.0% (22/25), while these values for breast lesions ＞1cm were 94.3% (100/106) and 71.4% (25/35), and these values for dense breast tissue were 94.0% (79/84) and 78.0% (39/50), as opposed to non-dense breast values of 97.0% (32/33) and 80.0% (8/10). The sensitivity of BSGI for invasive ductal carcinomas (IDC) and ductal carcinomas in situ (DCIS) were 98.9% (95/96) and 75.0% (9/12).The tumor to normal tissue ratio of BSGI for malignant lesions was significantly higher than that of benign lesions (2.18±1.17 vs 1.66±0.40, t =7.56, P ＜0.05). Conclusions : These results reveal that BSGI is highly sensitive, with good positive/negative predictive values. BSGI for IDC proved to be superior to DCIS for diagnosis of BI-RADS 4 category lesions as compared with ultrasound or mammography. BSGI showed perfect results in dense breasts and lesions ≤ 1 cm in size.

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Sonographic features of histopathologically benign solid breast lesions that have been classified as BI‐RADS 4 on sonography

Abstract: BI-RADS category 4 lesions demonstrate more than one suspicious ultrasonography feature, and biopsy is necessary to diagnose malignancy captured in 33% of lesions in this study. At this time, any lesion with more than one suspicious BI-RADS US feature cannot avoid a diagnostic biopsy.

Cited by 15 publications

References 14 publications

Breast Contrast-Enhanced Ultrasound: Is a Scoring System Feasible? ----A Preliminary Study in China

Breast Contrast-Enhanced Ultrasound: Is a Scoring System Feasible? ----A Preliminary Study in China

Epidermal inclusion cyst of the breast: A literature review

Comparison of 99mTc-MIBI scintigraphy, ultrasound, and mammography for the diagnosis of BI-RADS 4 category lesions

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