Ultrasonography.  2014 Jan;33(1):58-64.

Imaging features of complex sclerosing lesions of the breast

• Myong JH
• Choi BG
• Kim SH
• Kang BJ
• Lee A
• Song BJ

Abstract

PURPOSE
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%).
CONCLUSION
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.

Keyword

Breast; Ultrasonography; Mammography; Breast diseases

MeSH Terms

Biopsy, Large-Core Needle
Breast Diseases
Breast Neoplasms
Breast*
Carcinoma, Ductal
Carcinoma, Intraductal, Noninfiltrating
Classification
Follow-Up Studies
Information Systems
Mammography
Retrospective Studies
Ultrasonography