Non-mass finding (breast ultrasound)
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At the time the article was created Henry Knipe had no recorded disclosures.View Henry Knipe's current disclosures
At the time the article was last revised Andrew Murphy had no recorded disclosures.View Andrew Murphy's current disclosures
A non-mass finding on breast ultrasound refers to a discrete region of altered breast parenchymal echotexture that does make a mass shape (i.e. non-identifiable in two planes). "Non-mass finding" is not a current BI-RADS descriptor.
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Non-mass findings are described in numerous ways in the literature 1-3:
- non-mass lesion
- non-mass-like lesion
- non-mass image-forming lesion
- vague area of altered echotexture
- duct-like structures
- focal shadowing
Non-mass findings have been reported to occur in ~5% of diagnostic or screening breast ultrasound 4.
The malignancy rate for non-mass findings on breast ultrasound is unknown. Wide variations in benign rate (46-90%) and malignancy rate (10-54%) have been reported 1.
A wide range of benign and malignant conditions have been reported to represent non-mass findings including 1,2,4:
- benign: fibrocystic change, stromal fibrosis
- malignant: high-grade DCIS, breast cancer (ductal, lobular)
Non-mass findings are focal, linear-segmental or regional areas of altered breast echotexture that do not make a mass shape 1,2,4:
- hypoechoic, hyperechoic or mixed
- non-identified in two planes
- lack of conspicuous or biconvex margins
- lack of conspicuous shape
Associated features 1,3:
- calcifications (most commonly associated with malignancy)
- acoustic shadowing
- architectural distortion
- tubal or ductal architecture
The presence of ultrasound non-mass finding correlates of a mammographic finding (most commonly calcifications, asymmetric density, architectural distortion) are more associated with a malignant than benign pathology 1.
- 1. Jihee Choe, Sona A. Chikarmane, Catherine S. Giess. Nonmass Findings at Breast US: Definition, Classifications, and Differential Diagnosis. (2020) RadioGraphics. 40 (2): 326-335. doi:10.1148/rg.2020190125 - Pubmed
- 2. Kim HR, Jung HK. Histopathology findings of non-mass cancers on breast ultrasound. (2018) Acta radiologica open. 7 (6): 2058460118774957. doi:10.1177/2058460118774957 - Pubmed
- 3. Suk Jung Kim, Young Mi Park, Hyun Kyung Jung. Nonmasslike Lesions on Breast Sonography. (2014) Journal of Ultrasound in Medicine. 33 (3): 421. doi:10.7863/ultra.33.3.421 - Pubmed
- 4. Jong Won Park, Kyung Hee Ko, Eun-Kyung Kim, Cherie M Kuzmiak, Hae Kyoung Jung. Non-mass breast lesions on ultrasound: final outcomes and predictors of malignancy:. (2017) Acta Radiologica. 58 (9): 1054-1060. doi:10.1177/0284185116683574 - Pubmed