Echogenic Rind Associated With Suspicious Masses on Ultrasound: Performance for Breast Cancer Diagnosis and...

Area of Science:

• Radiology and Imaging
• Oncology
• Pathology

Background:

• The upcoming 6th edition of the Breast Imaging Reporting and Data System (BI-RADS) ultrasound lexicon may include 'echogenic rind' as a distinct associated feature.
• Echogenic rind is defined as a thick hyperechoic band that partially or completely encircles a mass, disrupting the surrounding tissue texture.

Purpose of the Study:

• To evaluate the diagnostic performance of echogenic rind in identifying breast malignancy on ultrasound.
• To explore the association between echogenic rind and pathological characteristics of breast tumors.

Main Methods:

• Retrospective analysis of diagnostic breast ultrasound examinations (BI-RADS category 4 or 5) and subsequent ultrasound-guided biopsies.
• Two radiologists independently assessed for the presence of echogenic rind (circumferential extent ≥ 25%) and measured masses with and without the rind.
• Diagnostic performance was determined using histopathology as the gold standard.

Main Results:

• The study included 511 patients with 583 suspicious masses; 249 were malignant.
• Echogenic rind showed specificity of 81% (reader 1) and 85% (reader 2) for malignancy, with sensitivity of 58% and 51%, respectively.
• The presence of echogenic rind was significantly associated with invasive cancers (invasive ductal carcinoma, invasive lobular carcinoma) and specific molecular subtypes (luminal A, HER2-enriched).

Conclusions:

• Echogenic rind is a more specific than sensitive imaging biomarker for breast malignancy on ultrasound.
• This finding is associated with invasive breast cancer and aids in reducing the underestimation of tumor size compared to surgical pathology.
• The presence of echogenic rind provides valuable clinical insights for breast cancer diagnosis and management.