Benign Versus Malignant Solid Breast Masses: US Differentiation

Retrospective study was aims to evaluate the significance of specific Ultrasonographic (US) imaging features to distinguish between benign and malignant solid breast masses, with biopsy (Cytologic or histologic) results as the reference standard and to determine whether solid breast masses that were diagnosed as probably benign only at ultrasonography (US) can be safely managed with follow-up. Materials & methods: One hundred females with solid breast nodules presented to KTH breast clinic for breast evaluation from April 2011 to April 2012. Sonographic features were compared finally with biopsy (FNAC) results. The significant statistical values of the sonographic features were calculated. The main study result was; the age range of the patients was between 15- 75 years with a mean age of 29 years. Benign histologic features were found in 76% lesions; malignant histologic features, in 24%. The US features most predictive of a benign tissue diagnosis were oval & round shaped (72%), well circumscribed margin (86.9%) and with macrolobulations (100%), with homogenous echo texture (94.4%), with dimensions of wider than deeper (91.9%), had posterior acoustic enhancement (90%) and the presence of thin echogenic pseudocapsule around the mass (100% of the masses with this feature were benign).The features most predictive of malignant tissue were speculated & mcirolobulated (86.7% and 66.7% respectively ), irregular shaped & ill-defined angular margin (81.8% and 78.6% ), with dimensions of deeper than wider (71.4% ), with posterior acoustic shadowing (75%), had ductal extension (100%) and showed heterogeneous echo texture (82.1%). Sonography can be used to accurately classify some solid lesions as benign, allowing imaging follow-up rather than biopsy.