Subcentimeter Solid Breast Lesions with Suspicious Ultrasonographic and Benign Histopathological Features: Sonographic Characterization

Abstract

Aim: The aim of our study was to reveal the types and sonographic features of the margins in solid lesions less than 10 mm in dimension, considered suspicious for malignancy in breast ultrasonography, and histopathologically diagnosed as benign; and therefore, to recall the features that will facilitate the evaluation of radiology-pathology compatibility after biopsy. Material and Methods: This study was conducted with 82 women, with BI-RADS 4-5 lesions sonographically, between 2017 and 2020. Lesion size and margins, presence of posterior shadowing and microcalcifications were scanned retrospectively. Lesions were classified according to their margins as smooth-macrolobulated, microlobulated, irregular-indistinct, angular and spiculated. Results: Histopathologically, the most common benign lesions were fibroadenoma (n=26, 31.7%) and fibrocystic changes (n=15, 18.3%). Sonographically, the mean size of the lesions was 8.96±1.46 mm, and the most common margins were irregular-indistinct in 39%, and smooth-macrolobulated in 30%. In the statistical analysis, the incidence of fibroadenoma was found to be significantly higher in the BI-RADS 4a group compared to the patients in the other pathological diagnosis group (p:0.007). Conclusion: In this study, it was concluded that the indistinct-irregular, microlobulated and angular margins could also be observed significantly in subcentimeter benign breast lesions, and as the size of the lesion got smaller, it becomes difficult to differentiate the features of the margins; hence they should be evaluated more carefully.

Keywords

• Benign breast lesions
• BI-RADS
• Sonographic margin
• Subcentimeter
• Ultrasonography

Sonografik Olarak Kuşkulu Olan ve Histopatolojik Olarak Benign Tanı Alan 1 cm’den Küçük Solid Meme Lezyonları: Sonografik Karakterizasyon

Öz

Amaç: Meme lezyonunun karakterini sonografik olarak değerlendirirken lezyon sınırları en önemli sonografik kriter olarak bilinir. Çalışmamızın amacı, meme ultrasonografi incelemesinde 10 mm ve daha küçük boyutlarda ölçülen ve malignite açısından kuşkulu değerlendirilen, histopatolojik olarak benign tanı alan solid lezyonların tiplerini ve sonografik kenar özelliklerini ortaya koymak; böylece biyopsi sonrası radyoloji-patoloji uyumunu değerlendirmeyi kolaylaştıracak özellikleri anımsamaktır. Materyal ve Metot: 2017-2020 tarihleri arasında, sonografik olarak BI-RADS 4-5 olarak raporlanan 82 kadın olgu çalışmaya dahil edildi. Kitle boyutları ve kenar özellikleri, kitlede posterior gölgelenme ve mikrokalsifikasyon varlığı retrospektif olarak tarandı. Lezyonlar kenar özelliklerine göre düzgün-makrolobüle, mikrolobüle, düzensiz-belirsiz, açılı ve spiküle olarak gruplandırıldı. Bulgular: Histopatolojik olarak en sık görülen benign lezyonlar fibroadenom (n=26, %31,7) ve fibrokistik değişiklikler (n=15, %18,3) dir. Lezyonların ortalama sonografik boyutu 8,96±1.46 mm ve sonografik kenar özellikleri %30’unda düzgün-makrolobüle, %12,2’sinde mikrolobüle, %39’unda düzensiz-belirsiz , %15,9’unda açılı ve %2,4’ünde spiküle idi. BI-RADS kategorisine göre lezyonların 48’i (%58,5) 4a, 29’u (%35,4) 4b, 3’ü (%3,7) 4c ve 2’si (%2,4) 5 olarak sınıflandırılmıştır. İstatistiksel analizde ise BI-RADS 4a grubunda fibroadenom olma oranı diğer patolojik tanı grubundaki olgulardan anlamlı düzeyde yüksek bulunmuştur (p:0.007). Sonuç: Bu çalışma ile 10 mm ve daha küçük benign meme lezyonlarında da kaydadeğer oranda düzensiz-belirsiz, mikrolobüle ve açılı kenar özelliklerinin görülebileceği, lezyon boyutları küçüldükçe kenar özelliklerinin ayrımının zor olduğu ve daha dikkatli değerlendirilmesi gerektiği sonucuna ulaşılmıştır.

Anahtar Kelimeler

• Benign meme lezyonları
• BI-RADS
• Sonografik kenar
• Subsantimetre
• Ultrasonografi

Kaynakça

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