AJR Podcasts Decoding Nonmass Lesions on Breast Ultrasound: Clinical Significance and Diagnostic Challenges
Jan 23, 2025
Delve into the intriguing world of non-mass lesions on breast ultrasound. The discussion sheds light on the diagnostic challenges these lesions present, emphasizing the need for standardized interpretation. Key findings about inter-reader agreement reveal how varied the assessments can be. Insights into imaging features linked to malignancy underscore the crucial role of accurate identification in clinical practice.
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Nature of Nonmass Lesions
- Non-mass lesions on breast ultrasound are less distinct and challenging to identify compared to well-defined masses.
- They lack clear shape or margins and are not yet included in BI-RADS but expected in the 6th edition.
Study Design and Definitions
- This study involved 2,381 breast lesions examined by two experienced radiologists for mass vs non-mass classification with consensus review.
- Non-mass lesions were defined by visibility in two planes without three-dimensional shape or conspicuity typical of masses.
Classification Agreement and Diagnostic Performance
- Interreader agreement for classifying lesions as mass vs non-mass was substantial (kappa 0.73).
- Ultrasound features such as calcifications and posterior shadowing had modest accuracy (~60%) in identifying malignancy in non-mass lesions.