What does Microlobulated margins mean? An irregular shape suggests a greater likelihood of malignancy. The margins can be described as circumscribed, microlobulated, obscured (partially hidden by adjacent tissue), indistinct (ill-defined), or spiculated (characterized by lines radiating from the mass).
What is microlobulated margin on ultrasound?
On ultrasound, margins of a mass are described as circumscribed or not circumscribed, which includes angular, microlobulated, indistinct, and spiculated. Thus, microlobulated is a term common to both the mammography and ultrasound BI-RADS® lexicons. Likewise, what is obscured margin?
What is a microlobulated mass?
Thus, microlobulated is a term common to both the mammography and ultrasound BI-RADS ® lexicons. This chapter, appearing in the section on asymmetry, mass, and distortion, reviews the key imaging features, imaging protocols and pitfalls, differential diagnoses, and management recommendations for microlobulated masses.
What does the presence of irregular margin and spiculation indicate?
Irregular margin or presence of spiculation indicate invasion of lesion into surrounding tissue. Sonographic spiculation consists of alternating hypoechoic and relatively hyperechoic lines radiating out from the nodule.
What is a spiculated margin in breast cancer?
Spiculated Lesion A dense, irregular mass with a spiculated margin that is not related to prior surgery is one of two combinations of features that is virtually diagnostic of malignancy (Fig. 16-9).
Does Microlobulated margins mean cancer?
Figure 16-24 A lesion with microlobulated margins has a high probability of malignancy. This is an example of a microlobulated mass, on the craniocaudal projection (A) and photographically enlarged (B), that proved to be an invasive breast cancer.
Can a Microlobulated mass be benign?
Circumscribed oval and round masses are usually benign. An irregular shape suggests a greater likelihood of malignancy. The margins can be described as circumscribed, microlobulated, obscured (partially hidden by adjacent tissue), indistinct (ill-defined), or spiculated (characterized by lines radiating from the mass).
Does angular margins mean cancer?
Angular margins observed on breast ultrasound are highly predictive of malignancy. If a solid breast nodule appears on ultrasound to be 'taller-than-wide', this is suspicious of malignancy.
Does spiculated always mean cancer?
16-7). Unless it is the site of a previous biopsy, a spiculated margin is very suspicious for malignancy. Cancers appear spiculated because of direct invasion into adjacent tissue or because of a desmoplastic reaction in the surrounding breast parenchyma.
Is a 5 mm breast lesion small?
T1mi is a tumor that is 1 mm or smaller. T1a is a tumor that is larger than 1 mm but 5 mm or smaller. T1b is a tumor that is larger than 5 mm but 10 mm or smaller. T1c is a tumor that is larger than 10 mm but 20 mm or smaller.
Can you tell if a lump is cancerous from an ultrasound?
Ultrasound cannot tell whether a tumor is cancer. Its use is also limited in some parts of the body because the sound waves can't go through air (such as in the lungs) or through bone.
Can a radiologist tell if it is breast cancer?
Some masses can be watched over time with regular mammograms or ultrasound to see if they change, but others may need to be checked with a biopsy. The size, shape, and margins (edges) of the mass can help the radiologist decide how likely it is to be cancer.
Can fibroadenomas be Microlobulated?
The margins of fibroadenomas were microlobulated in 44.9% of cases and indistinct in 21.8%. Echo patterns were hypoechoic and heterogeneous in 77.5 and 22.5% of fibroadenomas and 20.3 and 79.7% of phyllodes tumors, respectively. Posterior enhancement was detected in 29.5% of fibroadenomas and 40.6% of phyllodes tumors.
What does cancer look like on a mammogram?
What does breast cancer look like on a mammogram? Any area that does not look like normal tissue is a possible cause for concern. The radiologist will look for areas of white, high-density tissue and note its size, shape, and edges. A lump or tumor will show up as a focused white area on a mammogram.
Can spiculated margins be benign?
Although a spiculated mass is thought of as a classic finding of malignancy on mammography, ultrasound, and MRI, its differential diagnosis includes benign lesions.
What percentage of spiculated masses are cancer?
For example, a spiculated (or stellate) lesion has a high positive predictive value for malignancy, often around 90%2, whereas a mass with a circumscribed contour most often indicates a benign lesion (e.g. fibroadenoma, cyst or hamartoma)3.
What percent of spiculated masses are benign?
This is confirmed by this review of the first 8 years of screening in East Sussex where only 3.6% of masses with spiculation were benign at excision (24 out of 668), compared with 33.3% of masses without spiculation (102 out of 306).
What is an ill defined margin?
Lesions with Ill-Defined Margins. Ill definition of the margins of a lesion is a common, though nonspecific, characteristic that suggests a malignant process. Ill-defined margins are often due to superimposed normal breast tissues obscuring the margins of a lesion.
What is a breast cancer mass?
The classic description of a breast cancer is a mass with an irregular shape and spiculated margin ( Fig. 16-1 ). It has been our experience that many cancers that appear ill-defined on conventional, two-dimensional mammography appear so because their spiculated margins are hidden by superimposed tissues. By eliminating the “noise” of superimposed normal breast structures, many more cancers appear to have spiculated margins on digital breast tomosynthesis (DBT) ( Fig. 16-2 ). Diagnosis would be greatly simplified if all cancers of the breast exhibited similar unique features, but unfortunately they do not. Although many cancers have specific recognizable morphologic characteristics, there is an unavoidable similarity among the shapes, margins, and densities of many benign and malignant lesions. Some cancers produce an appearance that is virtually pathognomonic of the disease, but many do not exhibit such specific morphology. Until there are accurate, noninvasive ways to differentiate benign lesions from those that are malignant, some benign lesions will necessarily be biopsied to maximize the detection of early cancers.
Why is a negative mammogram considered a negative test?
Because the likelihood of cancer is so low, even in women with lumps, in most situations using a negative mammogram as indicative of no disease is successful simply based on the low probability of cancer being present to begin with, and not the test itself.
What is the first image of a mammogram?
The first image ( left) is an enlarged view of a cancer that is hidden on the conventional mammogram by overlapping normal tissue. The lesion is more clearly seen in the second image ( right) that is a slice from the tomosynthesis study.
Is mammography a diagnostic test?
Because of the frequent morphologic similarity between benign and malignant lesions, however, mammography is less useful as a diagnostic test where such differentiation is paramount. The safety and low morbidity of a breast biopsy makes it difficult to postpone the biopsy of a lesion when a significant doubt exists.
