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Complex Breast Masses: Assessment of Malignant Potential Based on Cyst Diameter.
MedLine Citation:
PMID:  22441915     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objectives- The purpose of this study was to assess whether cyst diameter might contribute to the prediction of malignancy in complex breast masses. Methods- In this cross-sectional study, we identified 48 breast masses that had sonographic features suggestive of benign breast lesions (oval shape, circumscribed margins, parallel axis, and abrupt limits). However, these masses were classified as Breast Imaging Reporting and Data System (BI-RADS) category 4 because of the presence of at least 1 cyst (complex echogenicity). All breast masses were biopsied (25 core needle and 23 core needle and excision). Subsequent histologic analysis was performed, and 12 malignancies (25%) were identified. Mammographic features were reviewed. Different sonographic measurements (largest diameters of the mass and cyst and vascular pattern) were assessed for the detection of malignancy. Results- Among the sonographic features, the vascular pattern, ie, the detection of blood flow (present in the lesion [P >.99] or present immediately adjacent to the lesion [P = .46]), was not associated with malignancy, whereas the largest mass and cyst dimensions had significantly positive correlations (P = .02; P < .001, respectively) with tumor malignancy. In receiver operating characteristic curve analysis, the point with the highest sum of sensitivity and specificity corresponded to a maximum cyst diameter of 8 mm (sensitivity, 67%; specificity, 86%). The positive and negative predictive values at that cutoff point were 61% and 86%, respectively. The area under the curve was 0.772. In this study, all masses with cysts smaller than 3 mm in diameter (7 cases) were benign, and all masses with cysts larger than 13 mm in diameter (4 cases) were malignant. Conclusions- Cyst diameter is a good predictor of malignancy in complex breast masses, which, except for the presence of internal cysts, would be otherwise classified as BI-RADS category 3.
Authors:
Rodrigo Menezes Jales; Luís Otavio Sarian; Cleisson Fábio Andrioli Peralta; Renato Torresan; Emílio Francisco Marussi; Beatriz Regina Alvares; Sophie Derchain
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine     Volume:  31     ISSN:  1550-9613     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-3-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211547     Medline TA:  J Ultrasound Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  581-587     Citation Subset:  -    
Affiliation:
MSc, Department of Obstetrics and Gynecology Faculty of Medical Sciences, State University of Campinas-Unicamp, PO Box 6111, Campinas, 13083-970 São Paulo-SP, Brazil., rodrigoj@hotmail.com.
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