Mixed and Purely Hyperechoic Breast Masses: A Radiologic-Pathologic Review

Area of Science:

• Radiology
• Oncology
• Pathology

Background:

• Breast ultrasound (US) is a key diagnostic tool in breast imaging.
• The BI-RADS atlas categorizes breast lesions based on echogenicity.
• Hyperechoic masses show increased echogenicity compared to surrounding tissue.

Purpose of the Study:

• To illustrate echogenic patterns of breast lesions.
• To correlate radiologic findings with pathology for hyperechoic masses.
• To raise awareness of malignant potential in heterogeneously hyperechoic lesions.

Main Methods:

• Review of breast ultrasound imaging.
• Classification of lesions according to BI-RADS echo patterns.
• Radiologic-pathologic correlation of hyperechoic masses.

Main Results:

• Hyperechoic patterns result from mixed tissue components (fat, fibrous tissue, secretions, vascularity, calcifications).
• Most homogeneously hyperechoic masses are benign.
• Malignant hyperechoic lesions can present with rim or dispersed patterns.

Conclusions:

• Hyperechogenicity alone does not rule out malignancy.
• Specific patterns within hyperechoic masses are indicative of malignancy.
• Radiologic-pathologic correlation is essential for accurate diagnosis of hyperechoic breast lesions.