Complex Cysts of the Breast: Analysis using Sonographic Breast Imaging Reporting and Data System

Son, Youn Mi; Kim, Eun Kyung; Kim, Min Jung; Moon, Hee Jung

Abstract

PURPOSE
The purpose of this study was to evaluate the usefulness of sonographic BI-RADS in differentiation between benignity and malignancy of complex breast cysts.
MATERIALS AND METHODS
Among 855 female patients who underwent ultrasound-guided core needle biopsy at our hospital from March 2012 through August 2012, 82 pathologically proven complex cysts detected on ultrasonography were included. The BI-RADS classification was made by radiologists prospectively and the imaging characterization of cystic lesions were classified retrospectively as cystic masses with a thick septa or thick wall, mixed solid and cystic masses, or solid masses with eccentric cystic foci. All lesions examined by ultrasonography were classified prospectively according to the BI-RADS lexicon. The pathologic findings were compared with sonographic appearance. We reviewed and compared the radiologic features between malignant lesions and benign lesions.
RESULTS
Finally, according to biopsy results, there were 71 benign and 11 (13.4%) malignant lesions. The frequency of malignancy was significantly higher in solid masses with eccentric cystic foci (p value <0.025). The size of sonographic lesions was significantly larger in malignant lesions than in benign lesions (41.82 mm+/-34.36 vs 18.41 mm+/-16.8 respectively, p=0.049). No statistically significant difference was observed in the sonographic findings according to the BI-RADS lexicon, however, statistically significant difference in final assessment categories was observed between benign and malignant lesions (p value <0.001).
CONCLUSIONS
The malignancy rate was higher in cystic lesions with predominantly solid masses and classified as suspicious malignancy using the BI-RADS lexicon.