Abstract
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.
Keywords
breast ultrasound - hyperechoic breast mass - mammography
