Breast lumps ultrasound: Difference between revisions

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|Subcutaneous and parenchymal edema with small fluid collection and diffuse hypervascularity
|Subcutaneous and parenchymal edema with small fluid collection and diffuse hypervascularity
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|Galactocele
|Galactocele<ref name="pmid233968884">{{cite journal| author=Masciadri N, Ferranti C| title=Benign breast lesions: Ultrasound. | journal=J Ultrasound | year= 2011 | volume= 14 | issue= 2 | pages= 55-65 | pmid=23396888 | doi=10.1016/j.jus.2011.03.002 | pmc=3558101 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23396888  }}</ref>
|Moderately echogenic contents with fat spreading heterogenously in the liquid component
|Moderately echogenic contents with fat spreading heterogenously in the liquid component
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|Seroma
|Seroma<ref name="pmid233968885">{{cite journal| author=Masciadri N, Ferranti C| title=Benign breast lesions: Ultrasound. | journal=J Ultrasound | year= 2011 | volume= 14 | issue= 2 | pages= 55-65 | pmid=23396888 | doi=10.1016/j.jus.2011.03.002 | pmc=3558101 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23396888  }}</ref>
|Anechoic or diffuse low-level echoes or thin fibrin septation. Blood presence may result in sediment, pseudonodule,wall-thickening and coarse septa formation
|Anechoic or diffuse low-level echoes or thin fibrin septation. Blood presence may result in sediment, pseudonodule,wall-thickening and coarse septa formation
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|Liponecrosis
|Liponecrosis<ref name="pmid233968886">{{cite journal| author=Masciadri N, Ferranti C| title=Benign breast lesions: Ultrasound. | journal=J Ultrasound | year= 2011 | volume= 14 | issue= 2 | pages= 55-65 | pmid=23396888 | doi=10.1016/j.jus.2011.03.002 | pmc=3558101 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23396888  }}</ref>
|A nodule with same feature as complex cyst
|A nodule with same feature as complex cyst
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|Hemangioma
|Hemangioma<ref name="pmid8689834">{{cite journal| author=Webb LA, Young JR| title=Case report: haemangioma of the breast--appearances on mammography and ultrasound. | journal=Clin Radiol | year= 1996 | volume= 51 | issue= 7 | pages= 523-4 | pmid=8689834 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8689834  }}</ref>
|Based on caliber of blood vessels
|Based on caliber of blood vessels
Capillary hemangioma: homogenouesly hyperechoic
Capillary hemangioma: homogenouesly hyperechoic
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Covernous hemangioma: mixed echotexture
Covernous hemangioma: mixed echotexture
|-
|-
|Fibroadenoma
|Fibroadenoma<ref name="pmid6600356">{{cite journal| author=Cole-Beuglet C, Soriano RZ, Kurtz AB, Goldberg BB| title=Fibroadenoma of the breast: sonomammography correlated with pathology in 122 patients. | journal=AJR Am J Roentgenol | year= 1983 | volume= 140 | issue= 2 | pages= 369-75 | pmid=6600356 | doi=10.2214/ajr.140.2.369 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6600356  }}</ref>
|Elliptic or lobulated shape, horizontal orientation,isoechoic or mildly hypoechoic echotexture, well-defined curvilinear margin with thin echogenic capsule, unaltered US beam transmission beyond the lesion and subtle acoustic shadows on both sides of the nodule
|Classic fibroadenoma: elliptic or lobulated shape, horizontal orientation,isoechoic or mildly hypoechoic echotexture, well-defined curvilinear margin with thin echogenic capsule, unaltered US beam transmission beyond the lesion and subtle acoustic shadows on both sides of the nodule
Complex fibroadenoma: heterogenous echotexture lesion with microcysts ( apocrine metaplasia) or small hyperechoic areas ( sclerosing adenosis)
Complex fibroadenoma: heterogenous echotexture lesion with microcysts ( apocrine metaplasia) or small hyperechoic areas ( sclerosing adenosis)
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|Moderately hypoechoic nodules with pseudocapsule, without posterior acoustic shadowing, sometimes pseudocystic spaces are so compressed which seem like hyperechoic striations
|Moderately hypoechoic nodules with pseudocapsule, without posterior acoustic shadowing, sometimes pseudocystic spaces are so compressed which seem like hyperechoic striations
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|Hamartoma
|Hamartoma<ref name="pmid2405180">{{cite journal| author=Adler DD, Jeffries DO, Helvie MA| title=Sonographic features of breast hamartomas. | journal=J Ultrasound Med | year= 1990 | volume= 9 | issue= 2 | pages= 85-90 | pmid=2405180 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2405180  }}</ref>
|Heterogenous appearance with mixture of isoechoic (adipose tissue/glandular lobules) and hyperechoic areas ( fibrous tissue)
|Heterogenous appearance with mixture of isoechoic (adipose tissue/glandular lobules) and hyperechoic areas ( fibrous tissue)
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|-

Revision as of 15:25, 11 December 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shadan Mehraban, M.D.[2]

Ultrasound

Indications of breast ultrasonography [1][2]

  • The first imagery modality in patients with palpable masses under 40 years old
  • Adjuntive modality to mammography for patients older than 40 years
  • Abnormal findings on mammography or MRI
  • Breast implants problems
  • Determination of mass with microcalcification and architectural distortion findings on mammography
  • Screening method for high risk individuals for breast cancer who can not undergo breast MRI
  • Evaluating axillary lymphadenopathy

Breast ultrasound improves breast cancer detection. According to the fact that 11% of palpable breast cancers were detected by ultrasound while these lesions were occult on mammography features. Combination of mammography and ultrasound increase cancer detection rate to 14% [3].

Types of breast lumps Characteristic findings
Cyst Simple cyst: well-circumscribed, anechoic contents, thin echogenic external capsule, enhanced through-transmission, subtle acoustic shadowing at the ages

complicated cyst: although not purely anechoic, diffuse echoes of low amplitude

Complex cyst: well-circumscribed anechoic mass with solid components

cysts with sediments: an anechoic mass containing sharp margins and posterior hyperechoic sediment

Abscess Hypo-anechoic mass with irregular margins and peripheral hypervascularity
Mastitis Subcutaneous and parenchymal edema with small fluid collection and diffuse hypervascularity
Galactocele[4] Moderately echogenic contents with fat spreading heterogenously in the liquid component
Seroma[5] Anechoic or diffuse low-level echoes or thin fibrin septation. Blood presence may result in sediment, pseudonodule,wall-thickening and coarse septa formation
Liponecrosis[6] A nodule with same feature as complex cyst
Hemangioma[7] Based on caliber of blood vessels

Capillary hemangioma: homogenouesly hyperechoic

Covernous hemangioma: mixed echotexture

Fibroadenoma[8] Classic fibroadenoma: elliptic or lobulated shape, horizontal orientation,isoechoic or mildly hypoechoic echotexture, well-defined curvilinear margin with thin echogenic capsule, unaltered US beam transmission beyond the lesion and subtle acoustic shadows on both sides of the nodule

Complex fibroadenoma: heterogenous echotexture lesion with microcysts ( apocrine metaplasia) or small hyperechoic areas ( sclerosing adenosis)

Phyllodes tumor Moderately hypoechoic nodules with pseudocapsule, without posterior acoustic shadowing, sometimes pseudocystic spaces are so compressed which seem like hyperechoic striations
Hamartoma[9] Heterogenous appearance with mixture of isoechoic (adipose tissue/glandular lobules) and hyperechoic areas ( fibrous tissue)
Papilloma Intraductal papilloma: well-circumscribed subareolar duct ectasiawith an iscoechoic, microlobulated surface on nodule

Intracystic papilloma: A cyst with prominent mass

References

  1. Shah R, Rosso K, Nathanson SD (2014). "Pathogenesis, prevention, diagnosis and treatment of breast cancer". World J Clin Oncol. 5 (3): 283–98. doi:10.5306/wjco.v5.i3.283. PMC 4127601. PMID 25114845.
  2. Lehman CD, Lee AY, Lee CI (2014). "Imaging management of palpable breast abnormalities". AJR Am J Roentgenol. 203 (5): 1142–53. doi:10.2214/AJR.14.12725. PMID 25341156.
  3. Moss HA, Britton PD, Flower CD, Freeman AH, Lomas DJ, Warren RM (1999). "How reliable is modern breast imaging in differentiating benign from malignant breast lesions in the symptomatic population?". Clin Radiol. 54 (10): 676–82. PMID 10541394.
  4. Masciadri N, Ferranti C (2011). "Benign breast lesions: Ultrasound". J Ultrasound. 14 (2): 55–65. doi:10.1016/j.jus.2011.03.002. PMC 3558101. PMID 23396888.
  5. Masciadri N, Ferranti C (2011). "Benign breast lesions: Ultrasound". J Ultrasound. 14 (2): 55–65. doi:10.1016/j.jus.2011.03.002. PMC 3558101. PMID 23396888.
  6. Masciadri N, Ferranti C (2011). "Benign breast lesions: Ultrasound". J Ultrasound. 14 (2): 55–65. doi:10.1016/j.jus.2011.03.002. PMC 3558101. PMID 23396888.
  7. Webb LA, Young JR (1996). "Case report: haemangioma of the breast--appearances on mammography and ultrasound". Clin Radiol. 51 (7): 523–4. PMID 8689834.
  8. Cole-Beuglet C, Soriano RZ, Kurtz AB, Goldberg BB (1983). "Fibroadenoma of the breast: sonomammography correlated with pathology in 122 patients". AJR Am J Roentgenol. 140 (2): 369–75. doi:10.2214/ajr.140.2.369. PMID 6600356.
  9. Adler DD, Jeffries DO, Helvie MA (1990). "Sonographic features of breast hamartomas". J Ultrasound Med. 9 (2): 85–90. PMID 2405180.