From: Ultrasound imaging of the lactating breast: methodology and application
Pathology | Ultrasonic appearances |
---|---|
Cyst | Margins – well circumscribed with thin smooth walls Centrally anechoic Posterior enhancement Edge shadowing No internal vascularity |
Fibroadenoma | Margins – well defined or occasionally ill-defined Echogenicity – homogenous to heterogenous No posterior enhancement unless internal calcification is present Internal vascularity |
Abscess | Margins – wide, indistinct, hypoechoic Echogenicity – predominantly echo-free to heterogenous Posterior enhancement No internal vascularity |
Malignancy | Margins – irregular and ill-defined Echogenicity – heterogenous echogenicity Stellate appearance +/- posterior shadowing Internal vascularity |
Galactocele | Acute – anechoic and simple or mainly anechoic with some diffuse echoes and multiloculated. Sub-acute – contain echoes of mild to moderate intensity Chronic – diffuse echogenicity ranging from moderate to highly echogenic Can be simple, multilocular and heterogenous Possible fat-fluid level Movement of the contents can be demonstrated by compression with the transducer Galactoceles are centrally devoid of blood vessels however flow may be demonstrated in the walls – use of colour Doppler can confirm this |
Blocked duct | Focal – similar appearances to an acute galactocele, non-compressible. Diffuse – often an area of increased echogenicity associated with a palpable solid region. Occasionally a hypoechoic rim surrounds a more echogenic central region |
Lactating adenoma | Margins – well circumscribed to ill-defined Echogenicity – hypo-, hyper or isoechoic Homo- or heterogenous Posterior enhancement or acoustic shadowing +/- internal vascularity |
Engorgement | Increased echogenicity of the glandular tissue due to the large volume of milk in the breast. Severe engorgement may exhibit ultrasonic signs similar to mastitis (see below) |
Mastitis | Early/acute phase: there may be no discernable ultrasonic changes in echogenicity breast tissues Skin – thickens and becomes more hyperechoic Cooper's ligaments and stromal fibrous tissue decrease in echogenicity Areas of inflammation frequently have increased blood flow Advanced stages: Skin thickening is prominent Distinction between different breast tissues disappears Breast thickness increases |