Cystic breast lesions by conventional ultrasonography: sonographic subtype-pathologic correlation and BI-RADS Assessment.
BACKGROUND
Appropriate categorization is very important because the clinical management of each subtype of cystic breast lesions (CBLs) differs. The purpose was to evaluate the sonographic subtype-pathologic correlation, and to identify the effectiveness of the Breast Imaging Reporting and Data System (BI-RADS)-ultrasound (US) for differentiation of benign and malignant CBLs.


METHODS
A database from December 1, 2007 and November 30, 2009 was identified in the Department of Diagnostic Ultrasound, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, China. Those patients with palpable or clinical symptomatic breast masses were associated with a cystic component in lesions on breast US. All patients underwent a subsequent fine-needle/core-needle biopsy or surgical excision. The sonographic findings were analyzed according to the BI-RADS-US, and were categorized by two different methods of subtype categorization compared with the pathologic results.


RESULTS
Ninety-nine breast cystic lesions in 83 women were included, among whom 16 patients were identified with bilateral cystic lesions. The total malignancy rate of CBLs was 14.1% (95% confidence interval 7.3-21.0%). Among 99 CBLs, 14 malignant lesions were associated with sonographic appearances of complex cystic lesions, while the remaining subtypes were benign. Shape, margin, echo pattern, orientation, calcification, and vascularity were statistically significantly different between the benign and malignant lesions (p = 0.010, p = 0.004, p < 0.001, p < 0.001, p = 0.036, and p < 0.001, respectively) (degrees of freedom = 1).


CONCLUSIONS
By comparison of the two different methods of subtype categorization of CBLs, the appropriate 5-variety classification should be suggested. The BI-RADS-US was useful for differentiating benign from malignant cystic lesions.
Department of Diagnostic Ultrasound, Zhong Shan Hospital, Fu Dan University School of Medicine, Shanghai, China ; Department of Diagnostic Ultrasound, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Man
M
Chen
Department of Diagnostic Ultrasound, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Wei Wei
WW
Zhan
Department of Diagnostic Ultrasound, Zhong Shan Hospital, Fu Dan University School of Medicine, Shanghai, China.
Wen Ping
WP
Wang
Breast Imaging Reporting and Data System; breast; pathology; subtype; ultrasonography