title: Imaging features of complex sclerosing lesions of the breast.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the imaging features of complex sclerosing lesions of the breast and to assess the rate of upgrade to breast cancer.
  
  
  METHODS
  From March 2008 to May 2012, seven lesions were confirmed as complex sclerosing lesions by ultrasonography-guided core needle biopsy. Final results by either surgical excision or follow-up imaging studies were reviewed to assess the rate of upgrade to breast cancer. Two radiologists retrospectively analyzed the imaging findings according to the Breast Imaging Reporting and Data System classification.
  
  
  RESULTS
  Five lesions underwent subsequent surgical excision and two of them revealed ductal carcinoma in situ (n=1) and invasive ductal carcinoma (n=1). Our study showed a breast cancer upgrade rate of 28.6% (2 of 7 lesions). Two lesions were stable on imaging follow-up beyond 1 year. The mammographic features included masses (n=4, 57.1%), architectural distortion (n=2, 28.6%), and focal asymmetry (n=1, 14.3%). Common B-mode ultrasonographic features were irregular shape (n=6, 85.7%), spiculated margin (n=5, 71.4 %), and hypoechogenicity (n=7, 100%). The final assessment categories were category 4 (n=6, 85.7%) and category 5 (n=1, 14.3%).
  
  
  CONCLUSIONS
  The complex sclerosing lesions were commonly mass-like on mammography and showed the suspicious ultrasonographic features of category 4. Due to a high underestimation rate, all complex sclerosing lesions by core needle biopsy should be excised.
authors.affiliation: Departments of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors.forename: Joo Hwa
authors.identifier: 0000-0002-8410-1102
authors.initials: JH
authors.lastname: Myong
authors.affiliation: Departments of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors.forename: Byung Gil
authors.identifier: 0000-0002-2950-2069
authors.initials: BG
authors.lastname: Choi
authors.affiliation: Departments of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors.forename: Sung Hun
authors.identifier: 0000-0003-4478-9720
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Departments of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors.forename: Bong Joo
authors.identifier: 0000-0002-5991-6035
authors.initials: BJ
authors.lastname: Kang
authors.affiliation: Departments of Pathology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors.forename: Ahwon
authors.identifier: 0000-0002-2523-9531
authors.initials: A
authors.lastname: Lee
authors.affiliation: Departments of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors.forename: Byung Joo
authors.identifier: 0000-0002-1461-5263
authors.initials: BJ
authors.lastname: Song
keywords: Breast; Breast diseases; Mammography; Ultrasonography