Analysis of normal breast tissue and of solid breast masses using three-dimensional ultrasound mammography

Objectives To describe the appearance of normal breast tissue and breast masses with three-dimensional ultrasound mammography, and evaluate the contribution of this to the diagnosis of breast masses. Materials and methods A total of 186 solid hypoechoic breast masses were analyzed with two- and three-dimensional ultrasonography. Three-dimensional planar reformatted sections were reconstructed along planes either orthogonal or parallel to the skin surface. Results With parallel planar reformatted sections all the masses tended to be round. Margins were clearly demonstrated. In case of carcinomas, circumferential jagging was present in the equatorial planes. In case of fibroadenomas, complete wall continuity of the mass was readily apparent. The hyperechoic bands of fibrous tissue peripheral to the masses appeared either as distinct from the central image (compressive pattern) or converged towards the hypoechoic central core of the mass, producing a stellar pattern (converging pattern). These two patterns were preferentially associated with benign lesions and carcinomas, respectively. Three-dimensional ultrasound mammography had higher specificity, but lower sensitivity, than two-dimensional ultrasound mammography. Conclusions Three-dimensional reconstruction, in particular parallel planar reformatted sections, represents a valuable adjunct to the characterization of breast masses using ultrasonography. Further studies are necessary to assess the validity of the present findings, particularly with regard to the rarer, more unusual types of carcinoma.