Breast cysts: pitfalls in sonographic diagnosis

Area of Science:

• Radiology
• Oncology
• Pathology

Background:

• Breast ultrasound is crucial for distinguishing cystic from solid masses.
• Some breast cysts present atypical features on ultrasound, challenging diagnosis.
• Internal echoes, irregular contours, and diminished through-transmission can be misleading.

Purpose of the Study:

• To highlight atypical echogenic breast cysts that mimic solid masses.
• To inform radiologists about including these cysts in differential diagnoses.
• To prevent misdiagnosis of benign cystic lesions as solid tumors.

Main Methods:

• Presentation of ten cases of atypical breast cysts.
• Detailed analysis of ultrasound features of these cysts.
• Confirmation of cystic nature via diagnostic aspiration.

Main Results:

• Atypical cysts exhibited internal echoes, irregular contours, or diminished through-transmission.
• Diagnostic aspiration confirmed all lesions as benign cysts.
• No cytologic evidence of malignancy or hemorrhage was found.

Conclusions:

• Echogenic cysts should be considered in the differential diagnosis of solid-appearing breast masses.
• Radiologists must be aware of these atypical cystic presentations.
• Accurate ultrasound interpretation can avoid unnecessary invasive procedures for benign cysts.