Analysis of the Accuracy of Ultrasound Elastography and BI-RADS Classification of Breast Masses Located Within the Superficial Fat Layer of the Glands

Overview

Journal Gland Surg

Publisher AME Publishing Company

Specialty Endocrinology

Date 2022 Nov 10

PMID 36353591

Authors

Nianyu Xue

Shengmin Zhang

Affiliations

Soon will be listed here.

Abstract

Background: The surrounding tissue of lesions located in the mammary fat layer is mainly fat, not mammary glands. Are the currently used Breast Imaging Reporting and Data System (BI-RADS) classifications and ultrasound elasticity appropriate for such lesions? In the present study, we discuss the value of elastography and BI-RADS classification in the evaluation of masses in the superficial fat layer of the breast.

Methods: Seventy-five breast masses within the fat layer that met inclusion criteria were included in the study. Using histopathology as the gold standard, we retrospectively analyzed whether the ultrasound elastography and BI-RADS classification results were consistent with the pathological results.

Results: Histological analysis showed that 73 tumors were benign and 2 were malignant. According to the BI-RADS classification and treatment principle, 60% (45/75) of the masses were classified into category 4 and require breast biopsy. But only 4.4% (2/45) of these masses were malignant, and 95.6% (43/45) were overtreated. If we consider the masses with well-defined margins and within the fat layer on the surface of the breast glands as likely benign (BI-RADS category 3), the probability of malignancy is 1.4%. This is consistent with the BI-RADS classification probability of malignancy. According to this BI-RADS classification, only 1.3% (1/75) of patients required biopsy.

Conclusions: The findings of this study suggest that breast masses located in the fat layer are prone to be classified into category 4 by BI-RADS and thus be subjected to unnecessary biopsies. Ultrasound elastography can easily misdiagnose benign masses as malignant. It is suggested that ultrasound elastography can downgrade the BI-RADS classification, but not upgrade it. It is more reasonable for these breast masses to be classified as BI-RADS 3 for follow-up observation when the boundary is clear.

Citing Articles

Diagnostic efficacy of ultrasound elastography and dynamic contrast-enhanced MR in benign and malignant breast masses.

Tao Z, Qi H, Ma Y Am J Transl Res. 2023; 15(4):2870-2877.

PMID: 37193163 PMC: 10182532.

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