Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Beyond BI-RADS: Nonmass Abnormalities on Breast Ultrasound

  • Hiroko Tsunoda (Department of Radiology, St. Luke's International Hospital) ;
  • Woo Kyung Moon (Department of Radiology, Seoul National University Hospital)
  • Received : 2023.08.16
  • Accepted : 2023.11.14
  • Published : 2024.02.01
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Abstract

Abnormalities on breast ultrasound (US) images which do not meet the criteria for masses are referred to as nonmass lesions. These features and outcomes have been investigated in several studies conducted by Asian researchers. However, the term "nonmass" is not included in the American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS) 5th edition for US. According to the Japan Association of Breast and Thyroid Sonology guidelines, breast lesions are divided into mass and nonmass. US findings of nonmass abnormalities are classified into five subtypes: abnormalities of the ducts, hypoechoic areas in the mammary glands, architectural distortion, multiple small cysts, and echogenic foci without a hypoechoic area. These findings can be benign or malignant; however, focal or segmental distributions and presence of calcifications suggest malignancy. Intraductal, invasive ductal, and lobular carcinomas can present as nonmass abnormalities. For the nonmass concept to be included in the next BI-RADS and be widely accepted in clinical practice, standardized terminologies, an interpretation algorithm, and outcome-based evidence are required for both screening and diagnostic US.

Keywords

Acknowledgement

The authors thank Dr. Naoki Kanomata, Department of pathology of St. Luke's International Hospital and Dr. Han Suk Ryu, Department of pathology of Seoul National University Hospital for histological images related to this work.

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