Breast ultrasound finding may signal invasive cancer, research suggests
New research suggests that one specific breast ultrasound finding is likely indicative of invasive cancers with molecular subtypes.
On ultrasound, echogenic rinds appear as thick, white bands of tissue that surround a mass. Though this finding is relatively uncommon, it is expected that the BI-RADS 6th edition ultrasound lexicon will include it as a feature associated with malignancy. As such, a team of experts at Duke University School of Medicine recently sought to determine the sensitivity and specificity of echogenic rinds visualized on breast ultrasound.
The retrospective analysis included patients who underwent a breast ultrasound showing a suspicious mass (BI-RADS category 4 or 5) and subsequent biopsy between July 1, 2022, and June 30, 2023. The exams were assessed by two radiologists who were tasked with identifying the presence of echogenic rinds (≥25% circumferential extent) specifically. The masses were measured with and without the bands included.
In total, 511 patients with 583 suspicious masses were included in the assessment. Of those 249 were eventually determined to be malignant. For the first reader, the presence of an echogenic rind yielded a sensitivity and specificity for malignancy of 58% and 81%; for the second reader, these figures were 51% and 85%. For both, the finding was often associated with invasive cancer (invasive ductal carcinoma [62%], invasive lobular carcinoma [57%], ductal carcinoma in situ [24%] for reader 1) and molecular subtypes.
Of the respective malignancies, the readers’ ultrasound measurements overestimated tumor size by about 3 mm to 7 mm compared to pathology, with slightly better accuracy when echogenic rinds were included.
“Recognition of echogenic rinds may provide radiologists with additional diagnostic confidence and improve preoperative tumor sizing,” lead researcher and 2022 Roentgen Fund recipient Derek L. Nguyen, MD, and colleagues concluded. “These findings support the anticipated addition of echogenic rind as an associated feature in the BI-RADS 6th edition ultrasound lexicon.”
The study abstract is available here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.