Which characteristics are evaluated on breast ultrasonography of focal disease?

Updated: Jan 24, 2017
  • Author: Durre Sabih, MBBS, MSc, FRCP(Edin); Chief Editor: Mahan Mathur, MD  more...
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This includes simple and complex cysts and solid masses. The following imaging characteristics are evaluated:

  • Size - Measured in the long and short axes, to document stability, regression or growth

  • Shape - Taller than wide, or wider than tall, extension along ducts

  • Surface - Smooth, irregular, macro or microlobulated, number of lobulations (up to 3 can be considered nonsuspicious), angular margins, spiculations, capsulation

  • Internal texture - Isoechoic, hyperechoic, or hypoechoic; heterogeneous or homogenous; complex; calcification; presence of echogenic, cystic center, or calcification

  • Surrounding tissue - Echogenic halo, radiating branches, whether the tissue pulled in toward the mass, and acoustic shadowing

  • Fixity - On real time ultrasound, fixity to surrounding tissue and underlying muscles can be assessed.

  • Doppler - Vascularity does not help in differentiating between benign and malignant, although benign lesions tend to be more hypovascular. Color Doppler can assist in planning an appropriate needle trajectory to avoid large vessels.

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