CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2021; 31(01): 018-023
DOI: 10.1055/s-0041-1729124
Review Article

Hyperechoic Lesions on Breast Ultrasound: All Things Bright and Beautiful?

S. K. Ramani
1  Department of Radiodiagnosis, Dr. D. Y. Patil Medical College, Navi Mumbai, Maharashtra, India
Ashita Rastogi
2  Department of Radiodiagnosis, Delhi State Cancer Institute, New Delhi, India
Nita Nair
3  Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
Tanuja M. Shet
4  Department of Pathology, Tata Memorial Hospital, Mumbai, Maharashtra, India
Meenakshi H. Thakur
5  Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, Maharashtra, India
› Author Affiliations


Ultrasound (US) lexicon of the Breast Imaging Reporting and Data System (BI-RADS) defines an echogenic breast mass as a lesion that is hyperechoic in comparison with subcutaneous adipose tissue. However, at sonography, only 0.6 to 5.6% of breast masses are echogenic and the majority of these lesions are benign. approximately, 0.5% of malignant breast lesions appear hyperechoic. The various benign pathologic entities that appear echogenic on US are lipoma, hematoma, seroma, fat necrosis, abscess, pseudoangiomatous stromal hyperplasia, galactocele, etc. The malignant diagnoses that may present as hyperechoic lesions on breast US are invasive ductal carcinoma, invasive lobular carcinoma, metastasis, lymphoma, and angiosarcoma. Echogenic breast masses need to be correlated with mammographic findings and clinical history. Lesions with worrisome features such as a spiculated margin, interval enlargement, interval vascularity, or association with suspicious microcalcifications on mammography require biopsy. In this article, we would like to present a pictorial review of patients who presented to our department with echogenic breast masses and were subsequently found to have various malignant as well as benign etiologies on histopathology.

Publication History

Publication Date:
19 April 2021 (online)

© 2021. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

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