Which ultrasonography (US) findings are characteristic of benign masses?

Updated: Feb 01, 2017
  • Author: Paul R Fisher, MD; Chief Editor: Eugene C Lin, MD  more...
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Many masses that are demonstrated on mammograms require biopsy to determine whether they are benign. Taylor et al reported that the use of US in conjunction with mammography increased specificity from 51% to 66% in a population with a malignancy prevalence of 31%. [54] This improvement could significantly reduce the biopsy rate of benign lesions. Breast US often reveals unexpected benign lesions.

Many benign breast conditions have a nonspecific appearance on US. However, some masses, such as simple cysts, sebaceous cysts, and intramammary lymph nodes, have a characteristic appearance that suggests a specific diagnosis. Almost all highly echogenic masses are benign.

If color Doppler imaging demonstrates blood flow within the contents of a complex cyst or dilated duct, then these contents consist of solid tissue rather then just debris, blood clot, or echogenic fluid. However, we have seen solid tumors that lack demonstrable blood flow on color Doppler imaging. Several investigators reviewed the ability of color Doppler US or contrast-enhanced Doppler US to distinguish benign from malignant lesions. The results were variable; Doppler US is not generally used to distinguish benign from malignant solid breast masses.

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