The predictive value of suspicious sonographic characteristics in atypical cyst-like breast lesions

Background and purpose: Simple breast cysts are a common sonographic finding and do not require further diagnostic evaluation. In contrast, atypical breast cysts do harbour a risk of malignancy. The purpose of this study was to evaluate the predictive value of sonographic findings that are considered characteristic of malignant atypical cyst-like lesions. Patients and methods: Six descriptive sonographic criteria of 202 atypical cysts in 176 women were compared with histopathological findings after surgical excision and their statistical association was evaluated. Results: Of these six criteria thick cyst wall (p < 0.0001), lobulation (p = 0.0001) and hyperechogenicity (p = 0.003) were found to be highly predictive of breast cancer. The presence of two or more sonographic criteria was associated with a 10.3 times greater risk of malignancy (p < 0.0001). Conclusion: The association between suspicious sonographic criteria and histology after surgery was evaluated. We propose surgical excision when two or more sonographic criteria are diagnosed in a single atypical breast cyst. (C) 2010 Elsevier Ltd. All rights reserved.