Diferenciação entre nódulos malignos e benignos da mama de acordo com as características sonográficas / Differentiation between malignant nodules and benign breast according to the sonographic characteristics

ABSTRACT

Introduction: The sonografic differentiation between solid and cystic lesions is relatively easy. On the other hand, the differentiation between benign and malign lumps isn't widely accepted and waits for further scientific evidences. Objective: To evaluate the odds ratio of malignity in each type of sonografic characteristics of solid nodular breast lesions. Methods: One hundred and forty two patients with solid nodular breast lesions, from the Department of Gynecology and Obstetrics of the Federal University of Goiás (Brazil), were included in the trial. A training doctor, always supervised by an experienced staff, has done all the ultrasounds and the characteristics of the lesions were carefully annotated in a specific data sheet. Each of the sonografic characteristics was analyzed in comparison to the results of the histological examination. Results: Among the 142 patients included in the trial, 90 (63%) had their lesions excised, and had the pathologic diagnosis of 77 (86%) benign tumors and 13 (14%) malign. The odds ratio of malignity in the solid breast tumors were the following those vertically oriented - taller than wide, 28,9 (5,9-140,8); retrotumoral shadowing, 13,5 (3,5-51,6); irregular shape, 10,2 (2,5-40,9); heterogeneous internal echoes, 7,9 (2,2-28,0); thickened Cooper ligaments, 6,3 (0,4-108,2); echogenic echoes anterior to the lump, 1,8 (0,4-7,6). Two cancers (15%) had all the characteristics suggestive of benignity. Conclusion: The ultrasound is a diagnostic method that can help physicians on the differentiation of the benign and malign lesions of the breast. The presence of some sonografic characteristics were related to the pathologic diagnosis of breast malignancies and when at least one of them is present, biopsy of the lesion should be recommended.