title: Sonographic differentiation of benign and malignant cystic lesions of the breast.
abstract: OBJECTIVE
  The purpose of this study was to subdivide the types of sonographic findings of benign versus malignant cystic masses and to determine appropriate patient care according to the sonographic findings with pathologic correlation.
  
  
  METHODS
  The sonographic findings of 175 symptomatic cystic breast lesions were pathologically proven and reviewed retrospectively. Cystic lesions were classified as 6 types: simple cysts (type I), clustered cysts (type II), cysts with thin septa (type III), complicated cysts (type IV), cystic masses with a thick wall/septa or nodules (type V), and complex solid and cystic masses (type VI). Sonographic findings were compared with the pathologic results and were evaluated according to the incidence of benign and malignant masses.
  
  
  RESULTS
  All 23 type I, 15 type II, 22 type III, and 35 type IV cases were pathologically proven to be benign. Seven (25.9%) of the 27 type V cases and 33 (62.3%) of the 53 type VI cases were proven to be malignant. We analyzed the shapes and margins of 80 cases of cystic masses with a solid component (types V and VI); 16 (44%) of 36 sonographically circumscribed masses were malignant.
  
  
  CONCLUSIONS
  Because the sonographically detected simple cysts (type I), clustered cysts (type II), and cysts with thin septa (type III) were all benign, annual routine follow-up appears reasonable. Symptomatic complicated cysts (type IV) should be aspirated and appropriately treated according to clinical symptoms. Cystic masses with a solid component (types V and VI) should be examined by biopsy with pathologic confirmation.
authors.affiliation: Department of Radiology, College of Medicine, Soonchunhyang University Hospital, Seoul, Korea. ywchang@hosp.sch.ac.kr
authors.forename: Yun-Woo
authors.initials: YW
authors.lastname: Chang
authors.forename: Kwi Hyang
authors.initials: KH
authors.lastname: Kwon
authors.forename: Dong Erk
authors.initials: DE
authors.lastname: Goo
authors.forename: Deuk Lin
authors.initials: DL
authors.lastname: Choi
authors.forename: Hye Kyung
authors.initials: HK
authors.lastname: Lee
authors.forename: Seung Boo
authors.initials: SB
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D047688:Breast Cyst / Q000145:classification / Q000000981:diagnostic imaging* / Q000473:pathology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D014463:Ultrasonography