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Breast
Lesion Imaging Characteristics
Ultrasound Lesion Characteristics
Complex Cystic and Solid Masses (US)
Complex Cystic and Solid Masses (US)
Wendie A. Berg, MD, PhD, FACR, FSBI
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KEY FACTS
Terminology
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Definitions
Mass with both cystic (anechoic) and solid (hypo-, iso-, or hyperechoic) components
Any of the following in isolation or combination
Intracystic mass
Thick-walled (≥ 0.5 mm), cystic mass
Thick septations (≥ 0.5 mm) within otherwise cystic mass
Predominantly cystic mass with solid component(s)
Predominantly solid mass with cystic (anechoic) areas
Distinguish from complicated cyst with debris
Circumscribed, oval mass with imperceptible wall, posterior enhancement
Homogeneous low-level echoes, mobile debris, or fluid-debris level
IMAGING
Mammographic Findings
Ultrasonographic Findings
MR Findings
CT Findings
Nuclear Medicine Findings
Imaging Recommendations
Image-Guided Biopsy
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
Jales RM et al: Complex breast masses: assessment of malignant potential based on cyst diameter. J Ultrasound Med. 31(4):581-7, 2012
Hsu HH et al: Complex cystic lesions of the breast on ultrasonography: feature analysis and BI-RADS assessment. Eur J Radiol. 79(1):73-9, 2011
Berg WA et al: Cystic breast masses and the ACRIN 6666 experience. Radiol Clin North Am. 48(5):931-87, 2010
Tea MK et al: The validity of complex breast cysts after surgery. Am J Surg. 197(2):199-202, 2009
Cardenosa G: Ultrasound of cysts, cystic lesions, and papillary lesions. Ultrasound Clin. 1:617-29, 2007
Chang YW et al: Sonographic differentiation of benign and malignant cystic lesions of the breast. J Ultrasound Med. 26(1):47-53, 2007
Berg WA et al: Cystic lesions of the breast: sonographic-pathologic correlation. Radiology. 227(1):183-91, 2003
Shetty MK et al: Sonographic findings in focal fibrocystic changes of the breast. Ultrasound Q. 18(1):35-40, 2002
Yilmaz E et al: Differentiation of phyllodes tumors versus fibroadenomas. Acta Radiol. 43(1):34-9, 2002
Venta LA et al: Management of complex breast cysts. AJR Am J Roentgenol. 173(5):1331-6, 1999
Soo MS et al: Fat necrosis in the breast: sonographic features. Radiology. 206(1):261-9, 1998
Warner JK et al: Apocrine metaplasia: mammographic and sonographic appearances. AJR Am J Roentgenol. 170(5):1375-9, 1998
Liberman L et al: Benign and malignant phyllodes tumors: mammographic and sonographic findings. Radiology. 198(1):121-4, 1996
Omori LM et al: Breast masses with mixed cystic-solid sonographic appearance. J Clin Ultrasound. 21(8):489-95, 1993
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Definitions
Mass with both cystic (anechoic) and solid (hypo-, iso-, or hyperechoic) components
Any of the following in isolation or combination
Intracystic mass
Thick-walled (≥ 0.5 mm), cystic mass
Thick septations (≥ 0.5 mm) within otherwise cystic mass
Predominantly cystic mass with solid component(s)
Predominantly solid mass with cystic (anechoic) areas
Distinguish from complicated cyst with debris
Circumscribed, oval mass with imperceptible wall, posterior enhancement
Homogeneous low-level echoes, mobile debris, or fluid-debris level
IMAGING
Mammographic Findings
Ultrasonographic Findings
MR Findings
CT Findings
Nuclear Medicine Findings
Imaging Recommendations
Image-Guided Biopsy
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
Jales RM et al: Complex breast masses: assessment of malignant potential based on cyst diameter. J Ultrasound Med. 31(4):581-7, 2012
Hsu HH et al: Complex cystic lesions of the breast on ultrasonography: feature analysis and BI-RADS assessment. Eur J Radiol. 79(1):73-9, 2011
Berg WA et al: Cystic breast masses and the ACRIN 6666 experience. Radiol Clin North Am. 48(5):931-87, 2010
Tea MK et al: The validity of complex breast cysts after surgery. Am J Surg. 197(2):199-202, 2009
Cardenosa G: Ultrasound of cysts, cystic lesions, and papillary lesions. Ultrasound Clin. 1:617-29, 2007
Chang YW et al: Sonographic differentiation of benign and malignant cystic lesions of the breast. J Ultrasound Med. 26(1):47-53, 2007
Berg WA et al: Cystic lesions of the breast: sonographic-pathologic correlation. Radiology. 227(1):183-91, 2003
Shetty MK et al: Sonographic findings in focal fibrocystic changes of the breast. Ultrasound Q. 18(1):35-40, 2002
Yilmaz E et al: Differentiation of phyllodes tumors versus fibroadenomas. Acta Radiol. 43(1):34-9, 2002
Venta LA et al: Management of complex breast cysts. AJR Am J Roentgenol. 173(5):1331-6, 1999
Soo MS et al: Fat necrosis in the breast: sonographic features. Radiology. 206(1):261-9, 1998
Warner JK et al: Apocrine metaplasia: mammographic and sonographic appearances. AJR Am J Roentgenol. 170(5):1375-9, 1998
Liberman L et al: Benign and malignant phyllodes tumors: mammographic and sonographic findings. Radiology. 198(1):121-4, 1996
Omori LM et al: Breast masses with mixed cystic-solid sonographic appearance. J Clin Ultrasound. 21(8):489-95, 1993
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