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DOI: 10.1055/s-0044-1779589
Approach to Nonmass Lesions on Breast Ultrasound
Funding None.
Abstract
Nonmass lesions in breast ultrasound (US) are areas of altered echogenicity without definite margins or mass effect. However, these lesions may show calcifications, associated architectural distortion, or shadowing just like masses. They vary in their echogenicity, distribution, ductal or nonductal appearance and the associated features that can be seen in variety of benign and malignant pathologies. With no uniform definition or classification system, there is no standardized approach in further risk categorization and management strategies of these lesions. Malignant nonmass lesions are not uncommon and few sonographic features can help in differentiating benign and malignant pathologies. US-guided tissue sampling or lesion localization can be preferred in the nonmass lesions identified on second look US after magnetic resonance imaging or mammography. This article aims to describe various imaging patterns and attempts to provide an algorithmic approach to nonmass findings on breast US.
Authors' Contributions
S.L.M. contributed to resources and writing—original draft. E.D. helped in conceptualization, resources, writing—review and editing, and supervision. R.G. was involved in writing—review and editing.
Publikationsverlauf
Artikel online veröffentlicht:
23. Februar 2024
© 2024. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Mendelson EB, Böhm-Vélez M, Berg WA, Whitman GJ, Feldman MI, Madjar H. Acr bi-rads® ultrasound. ACR BI-RADS® atlas, breast imaging reporting and data system. 2013;149.
- 2 Choe J, Chikarmane SA, Giess CS. Nonmass findings at breast US: definition, classifications, and differential diagnosis. Radiographics 2020; 40 (02) 326-335
- 3 Kim SJ, Park YM, Jung HK. Nonmasslike lesions on breast sonography: comparison between benign and malignant lesions. J Ultrasound Med 2014; 33 (03) 421-430
- 4 Ko ES, Choi HY, Kim RB, Noh WC. Application of sonoelastography: comparison of performance between mass and non-mass lesion. Eur J Radiol 2012; 81 (04) 731-736
- 5 Lee J, Lee JH, Baik S. et al. Non-mass lesions on screening breast ultrasound. Med Ultrason 2016; 18 (04) 446-451
- 6 Yamaguchi R, Watanabe H, Mihara Y, Yamaguchi M, Tanaka M. Histopathology of non-mass-like breast lesions on ultrasound. J Med Ultrason 2023; 50 (03) 375-380
- 7 Endo T, Kubota M, Konishi Y. et al. Draft Diagnostic Guidelines for Non-Mass Image-Forming Lesions by the Japan Association of Breast and Thyroid Sonology (JABTS) and the Japan Society of Ultrasonics in Medicine. In: Ueno E, Shiina T, Kubota M, Sawai K. eds. Research and Development in Breast Ultrasound. Tokyo: Springer; 2005: 89-100
- 8 Uematsu T. Non-mass-like lesions on breast ultrasonography: a systematic review. Breast Cancer 2012; 19 (04) 295-301
- 9 Ko KH, Hsu HH, Yu JC. et al. Non-mass-like breast lesions at ultrasonography: feature analysis and BI-RADS assessment. Eur J Radiol 2015; 84 (01) 77-85
- 10 Wang ZL, Li N, Li M, Wan WB. Non-mass-like lesions on breast ultrasound: classification and correlation with histology. Radiol Med (Torino) 2015; 120 (10) 905-910
- 11 Park JW, Ko KH, Kim EK, Kuzmiak CM, Jung HK. Non-mass breast lesions on ultrasound: final outcomes and predictors of malignancy. Acta Radiol 2017; 58 (09) 1054-1060
- 12 Giess CS, Chesebro AL, Chikarmane SA. Ultrasound features of mammographic developing asymmetries and correlation with histopathologic findings. Am J Roentgenol 2018; 210 (01) W29-W38
- 13 Ito T, Ueno E, Endo T. et al. The Japan Society of Ultrasonics in Medicine guidelines on non-mass abnormalities of the breast. J Med Ultrason 2023; 50 (03) 331-339
- 14 Gao Y, Slanetz PJ, Eisenberg RL. Echogenic breast masses at US: to biopsy or not to biopsy?. Radiographics 2013; 33 (02) 419-434
- 15 Ferris-James DM, Iuanow E, Mehta TS, Shaheen RM, Slanetz PJ. Imaging approaches to diagnosis and management of common ductal abnormalities. Radiographics 2012; 32 (04) 1009-1030
- 16 Uematsu T. Non-mass lesions on breast ultrasound: why does not the ACR BI-RADS breast ultrasound lexicon add the terminology?. J Med Ultrason 2023; 50 (03) 341-346
- 17 Sefidbakht S, Haseli S, Khalili N, Bazojoo V, Keshavarz P, Zeinali-Rafsanjani B. Can shear wave elastography be utilized as an additional tool for the assessment of non-mass breast lesions?. Ultrasound 2022; 30 (01) 44-51
- 18 Zhang F, Jin L, Li G. et al. The role of contrast-enhanced ultrasound in the diagnosis of malignant non-mass breast lesions and exploration of diagnostic criteria. Br J Radiol 2021; 94 (1120): 20200880
- 19 Zhang W, Xiao X, Xu X. et al. Non-mass breast lesions on ultrasound: feature exploration and multimode ultrasonic diagnosis. Ultrasound Med Biol 2018; 44 (08) 1703-1711
- 20 Leong PW, Chotai NC, Kulkarni S. Imaging features of inflammatory breast disorders: a pictorial essay. Korean J Radiol 2018; 19 (01) 5-14
- 21 Tan H, Li R, Peng W, Liu H, Gu Y, Shen X. Radiological and clinical features of adult non-puerperal mastitis. Br J Radiol 2013; 86 (1024): 20120657
- 22 Alikhassi A, Azizi F, Ensani F. Imaging features of granulomatous mastitis in 36 patients with new sonographic signs. J Ultrasound 2020; 23 (01) 61-68
- 23 Kim J, Kim EK, Kim MJ, Moon HJ, Yoon JH. Diabetic mastopathy: imaging features and the role of image-guided biopsy in its diagnosis. Ultrasonography 2016; 35 (02) 140-147
- 24 Kim YR, Kim HS, Kim HW. Are irregular hypoechoic breast masses on ultrasound always malignancies?: a pictorial essay. Korean J Radiol 2015; 16 (06) 1266-1275
- 25 Mesurolle B, Perez JCH, Azzumea F. et al. Atypical ductal hyperplasia diagnosed at sonographically guided core needle biopsy: frequency, final surgical outcome, and factors associated with underestimation. AJR Am J Roentgenol 2014; 202 (06) 1389-1394
- 26 Chen YL, Chen JJ, Chang C. et al. Sclerosing adenosis: ultrasonographic and mammographic findings and correlation with histopathology. Mol Clin Oncol 2017; 6 (02) 157-162
- 27 Trombadori CML, D'Angelo A, Ferrara F, Santoro A, Belli P, Manfredi R. Radial scar: a management dilemma. Radiol Med (Torino) 2021; 126 (06) 774-785
- 28 Takei J, Tsunoda-Shimizu H, Kikuchi M. et al. Clinical implications of architectural distortion visualized by breast ultrasonography. Breast Cancer 2009; 16 (02) 132-135
- 29 Bilgen IG, Ustun EE, Memis A. Fat necrosis of the breast: clinical, mammographic and sonographic features. Eur J Radiol 2001; 39 (02) 92-99
- 30 Jin ZQ, Lin MY, Hao WQ. et al. Diagnostic evaluation of ductal carcinoma in situ of the breast: ultrasonographic, mammographic and histopathologic correlations. Ultrasound Med Biol 2015; 41 (01) 47-55
- 31 Watanabe T, Yamaguchi T, Tsunoda H. et al. Ultrasound image classification of ductal carcinoma in situ (DCIS) of the breast: analysis of 705 DCIS lesions. Ultrasound Med Biol 2017; 43 (05) 918-925
- 32 Gunawardena DS, Burrows S, Taylor DB. Non-mass versus mass-like ultrasound patterns in ductal carcinoma in situ: is there an association with high-risk histology?. Clin Radiol 2020; 75 (02) 140-147
- 33 Choi BB, Kim SH, Park CS, Cha ES, Lee AW. Radiologic findings of lobular carcinoma in situ: mammography and ultrasonography. J Clin Ultrasound 2011; 39 (02) 59-63
- 34 Lamb PM, Perry NM, Vinnicombe SJ, Wells CA. Correlation between ultrasound characteristics, mammographic findings and histological grade in patients with invasive ductal carcinoma of the breast. Clin Radiol 2000; 55 (01) 40-44
- 35 Selinko VL, Middleton LP, Dempsey PJ. Role of sonography in diagnosing and staging invasive lobular carcinoma. J Clin Ultrasound 2004; 32 (07) 323-332
- 36 Shetty MK, Watson AB. Sonographic evaluation of focal asymmetric density of the breast. Ultrasound Q 2002; 18 (02) 115-121
- 37 Bahl M, Baker JA, Kinsey EN, Ghate SV. Architectural distortion on mammography: correlation with pathologic outcomes and predictors of malignancy. AJR Am J Roentgenol 2015; 205 (06) 1339-1345
- 38 Hong MJ, Cha JH, Kim HH. et al. Second-look ultrasonography for MRI-detected suspicious breast lesions in patients with breast cancer. Ultrasonography 2015; 34 (02) 125-132
- 39 Coskun Bilge A, Demir PI, Aydin H, Bostanci IE. Dynamic contrast-enhanced breast magnetic resonance imaging findings that affect the magnetic resonance-directed ultrasound correlation of non-mass enhancement lesions: a single-center retrospective study. Br J Radiol 2022; 95 (1132): 20210832
- 40 Sotome K, Yamamoto Y, Hirano A. et al. The role of contrast enhanced MRI in the diagnosis of non-mass image-forming lesions on breast ultrasonography. Breast Cancer 2007; 14 (04) 371-380
- 41 Lin M, Wu S. Ultrasound classification of non-mass breast lesions following BI-RADS presents high positive predictive value. PLoS One 2022; 17 (11) e0278299