title: Risk of malignancy in solid breast nodules according to their sonographic features.
abstract: OBJECTIVE
  The purpose of this study was to assess the risk of malignancy for each type of sonographic feature in solid breast nodules.
  
  
  METHODS
  The study included 304 patients from the Department of Gynecology and Obstetrics of the Federal University of Goiás who had solid breast nodules. A medical trainee, working under the supervision of a preceptor, obtained the sonographic images of the breast, and the features were recorded in a questionnaire. Each sonographic feature was analyzed and compared with the anatomic and pathologic findings after the lesion was excised.
  
  
  RESULTS
  Of the 304 patients included in the study, 292 (96%) had a conclusive diagnosis. Among these women, 216 (74%) had benign tumors and 76 (26%) had malignant tumors. The odds ratio of malignancy in breast nodules, as calculated by multivariate analysis, was as follows: lesions without circumscribed margins, 17.02 (95% confidence interval, 5.28-54.90); lesions with heterogeneous echo texture, 7.70 (2.99-19.84); lesions with thickened Cooper ligaments, 15.61 (1.08-225.10); nodules whose anteroposterior dimension was larger than their width, 3.29 (1.09-9.96); those with an anterior echogenic rim, 2.59 (0.80-8.40); and those with posterior shadowing, 1.57 (0.62-4.01). Among the 133 cases that had all the sonographic features of a benign lesion, 3 nodules (2.3%) had a histologic diagnosis of malignant.
  
  
  CONCLUSIONS
  Sonography is a diagnostic method that can help establish the differentiation between benign and malignant solid tumors. A lack of circumscribed margins, heterogeneous echo patterns, thickened Cooper ligaments, and an increased anteroposterior dimension can indicate a higher probability of malignancy in solid breast nodules.
authors.affiliation: Department of Gynecology and Obstetrics, School of Medicine, Federal University of Goiás, Goiás, Brazil.
authors.forename: Régis Resende
authors.initials: RR
authors.lastname: Paulinelli
authors.forename: Ruffo
authors.initials: R
authors.lastname: Freitas-Júnior
authors.forename: Marise Amaral Rebouças
authors.initials: MA
authors.lastname: Moreira
authors.forename: Vardeli Alves de
authors.initials: VA
authors.lastname: Moraes
authors.forename: Júlio Roberto M
authors.initials: JR
authors.lastname: Bernardes-Júnior
authors.forename: Célio da Silva Rocha
authors.initials: Cda S
authors.lastname: Vidal
authors.forename: Alessandro Naldi
authors.initials: AN
authors.lastname: Ruiz
authors.forename: Miliana Tostes
authors.initials: MT
authors.lastname: Lucato
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D016217:Ultrasonography, Mammary