Cystic lesions are very commonly encountered entities in the breast. Among these, Complex Cystic Breast Masses (CCBMs), which
contain both anechoic and echogenic
components, can result in a variety of imaging appearances. These
include cystic lesions with thick walls and/or internal septa, intracystic
nodular lesions, and solid-cystic masses of varying compositions. Ultrasound is
the mainstay for evaluating cystic lesions, and thus recognizing the imaging
features appropriately and suggesting suitable interventional procedures are included in their management. In this pictorial
essay, we describe the wide range of ultrasound appearances of CCBMs with a number of clinically
encountered examples from our institution. This article would enhance the
understanding of readers in possible differentials to be included in their
clinical practice and to suggest appropriate
further intervention, when deemed necessary.
References
[1]
Doshi, D.J., March, D.E., Crisi, G.M. and Coughlin, B.F. (2007) Complex Cystic Breast Masses: Diagnostic Approach and Imaging-Pathologic Correlation. RadioGraphics, 27, S53-S64. https://doi.org/10.1148/rg.27si075508
[2]
Berg, W.A., Campassi, C.I. and Ioffe, O.B. (2003) Cystic Lesions of the Breast: Sonographic-Pathologic Correlation. Radiology, 227, 183-191.
https://doi.org/10.1148/radiol.2272020660
[3]
Cho, S.H. and Park, S.H. (2013) Mimickers of Breast Malignancy on Breast Sonography. Journal of Ultrasound in Medicine, 32, 2029-2036.
https://doi.org/10.7863/ultra.32.11.2029
[4]
Solorzano, S., Mesurolle, B., Omeroglu, A., El Khoury, M., Kao, E., Aldis, A., et al. (2011) Flat Epithelial Atypia of the Breast: Pathological-Radiological Correlation. American Journal of Roentgenology, 197, 740-746.
https://doi.org/10.2214/AJR.10.5265
[5]
Gokhale, S. (2009) Ultrasound Characterization of Breast Masses. Indian Journal of Radiology and Imaging, 19, 242-247.
[6]
Warner, J.K., Kumar, D. and Berg, W.A. (1998) Apocrine Metaplasia: Mammographic and Sonographic Appearances. American Journal of Roentgenology, 170, 1375-1379.
https://doi.org/10.2214/ajr.170.5.9574619
[7]
Sarakbi, W.A., Worku, D., Escobar, P.F. and Mokbel, K. (2006) Breast Papillomas: Current Management with a Focus on a New Diagnostic and Therapeutic Modality. International Seminars in Surgical Oncology, 3, Article No. 1.
https://doi.org/10.1186/1477-7800-3-1
[8]
Eiada, R., Chong, J., Kulkarni, S., Goldberg, F. and Muradali, D. (2012) Papillary Lesions of the Breast: MRI, Ultrasound, and Mammographic Appearances. American Journal of Roentgenology, 198, 264-271. https://doi.org/10.2214/AJR.11.7922
[9]
Mesurolle, B., Perez, J.C.H., Azzumea, F., Lemercier, E., Xie, X., Aldis, A., et al. (2014) Atypical Ductal Hyperplasia Diagnosed at Sonographically Guided Core Needle Biopsy: Frequency, Final Surgical Outcome, and Factors Associated With Underestimation. American Journal of Roentgenology, 202, 1389-1394.
https://doi.org/10.2214/AJR.13.10864
[10]
Taboada, J.L., Stephens, T.W., Krishnamurthy, S., Brandt, K.R. and Whitman, G.J. (2009) The Many Faces of Fat Necrosis in the Breast. American Journal of Roentgenology, 192, 815-825. https://doi.org/10.2214/AJR.08.1250
[11]
Lee, J.H., Kim, S.H., Kang, B.J., Lee, A.W. and Song, B.J. (2010) Ultrasonographic Features of Benign Adenomyoepithelioma of the Breast. Korean Journal of Radiology, 11, 522-527.
[12]
Kim, M.J., Kim, E.K., Park, S.Y., Jung, H.K., Oh, K.K. and Seok, J.Y. (2006) Galactocoeles Mimicking Suspicious Solid Masses on Sonography. Journal of Ultrasound in Medicine, 25, 145-151. https://doi.org/10.7863/jum.2006.25.2.145
[13]
Chung, S.Y., Oh, K.K. and Kim, D.J. (2003) Mammographic and Sonographic Findings of a Breast Cystic Lymphangioma. Journal of Ultrasound in Medicine, 22, 307-309.
https://doi.org/10.7863/jum.2003.22.3.307
[14]
Kalambo, M., Adrada, B.E., Adeyefa, M.M., Krishnamurthy, S., Hess, K., Carkaci, S., et al. (2018) Phyllodes Tumour of the Breast: Ultrasound-Pathology Correlation. American Journal of Roentgenology, 210, W173-W179.
https://doi.org/10.2214/AJR.17.18554
[15]
Gupta, K., Kumaresan, M., Venkatesan, B., Chandra, T., Patil, A. and Menon, M. (2018) Sonographic Features of Invasive Ductal Breast Carcinomas Predictive of Malignancy Grade. Indian Journal of Radiology and Imaging, 28, 123-131.
https://doi.org/10.4103/ijri.IJRI_257_17
[16]
Lam, W.W.M., Chu, W.C.W., Tse, G.M. and Ma, T.K. (2004) Sonographic Appearance of Mucinous Carcinoma of the Breast. American Journal of Roentgenology, 182, 1069-1074. https://doi.org/10.2214/ajr.182.4.1821069
[17]
Wang, L., Sullivan, M., Du, H., Feldman, M.I. and Mendelson, E.B. (2013) US Appearance of Ductal Carcinoma in Situ. RadioGraphics, 33, 213-228.
https://doi.org/10.1148/rg.331125092
[18]
Dogan, B.E., Whitman, G.J., Middleton, L.P. and Phelps, M. (2003) Intracystic Papillary Carcinoma of the Breast. American Journal of Roentgenology, 181, 186.
https://doi.org/10.2214/ajr.181.1.1810186
[19]
Günhan-Bilgen, I., Memis, A., Ustün, E.E., Zekioglu, O. and Ozdemir, N. (2002) Metaplastic Carcinoma of the Breast: Clinical, Mammographic, and Sonographic Findings with Histopathologic Correlation. American Journal of Roentgenology, 178, 1421-1425.
https://doi.org/10.2214/ajr.178.6.1781421
[20]
Lim, R.F. and Goei, R. (2007) Angiosarcoma of the Breast. RadioGraphics, 27, S125-S130. https://doi.org/10.1148/rg.27si075016
