Objective:

To explore the mammography

ultrasound

pathology and clinical features of patients with multiple breast masses.

Methods:

Retrospective analysis of patients with multiple breast masses (at least 3 masses) on mammography and ultrasound from Jan. 2005 to Nov. 2019. The age

menopausal status

pathological types and imaging characteristics ［breast composition

mass morphology

density

margin

maximum mass diameter

calcification and Breast Imaging Reporting and Data System (BI-RADS) classification］ of the patients were recorded. BI-RADS 2-3 were classified as benign

BI-RADS 4~5 were classified as malignant. First

compared the clinical

pathological and imaging differences of unilateral and bilateral multiple masses，then compared the accuracy of mammography and ultrasound in diagnosis of multiple breast masses.

Results:

Among the 105 cases of multiple breast masses

99 cases (94.29%) were benign (52 cases of fibroadenoma

24 cases of fibrocystic adenosis

13 cases of breast adenosis

7 cases of intraductal papilloma

2 cases of cyst

1 case of benign lobar tumor)

and 6 cases were malignant (4 cases of triple-negative breast cancer and 2 cases of mucinous carcinoma). There were no significant differences in age

menopausal status

maximum diameter and pathological malignancy of patients with unilateral and bilateral multiple masses

but significant differences in age

menopausal status

masse morphology

margin and BI-RADS classification of benign and malignant masses (

P

＜0.05). The onset age of patients with benign multiple masses was (43.256.69) years old

lower than that malignant tumors patients ［(50.009.19) years old］

mainly non-menopausal (88.89%). Mammography and ultrasound showed that the lesions of category BI-RADS 2 and BI-RADS 5 were consistent with pathological results. The malignant lesions diagnosed as BI-RADS 3 (1/67) and benign lesions diagnosed as BI-RAD

S 4 (24/25) by mammography were both due to the obscured margin of the mass

but the ultrasonic diagnosis of these cases was basically consistent with pathology. The pathological results of ultrasound diagnosis of BI-RADS 3 were all benign

however

in 90.00% (9/10) of BI-RADS 4 were benign

the diagnosis was upgraded due to calcification in the masses

but mammography showed all benign calcification. The sensitivity and specificity of ultrasonic diagnosis of multiple breast masses were 100.00% and 90.91%

and the area under curve (AUC) was 0.96. Mammography showed sensitivity of 83.33% and specificity of 75.76%

and AUC of 0.80.

Conclusion:

① The pathological features of multiple breast masses were mostly benign

patients with malignant multiple masses were older than benign. ② The accuracy of ultrasonic diagnosis of multiple breast masses is higher than mammography

combination of two imaging methods can further improve the accuracy of diagnosis

but not all patients need to undergo the two imaging examinations. ③ When mammography presents a mass with obscured margin

ultrasound should be considered for further examination. ④ When ultrasonography is diagnosed as malignant due to calcification

mammography is recommended to further analyze the morphology and distribution of calcification.