The Contribution of a Solid Breast Mass Gray-Scale Histographic Analysis in Ascertaining a Benign-Malignant Differentiation

Abstract

Objective: The aim of this study was to determine the efficiency of a fat-lesion histographic analysis (FLHA) to make a benign-malignant differentiation, for patients with a breast mass. In addition, it was important to examine the relationship between FLHA rates and Breast Imaging–Reporting and Data System (BI-RADS) scoring. Materials and Methods: This was a retrospective study conducted by examining the breast ultrasonograms (BUS) and histopathologic data of 76 women, having at least one solid breast mass. The patients were grouped according to their histopathologic diagnoses and BUS BI-RADS scores. The recorded digital gray-scale images were transferred to a workstation to quantitatively measure tissue echogenicity. The breast masses and adjacent adipose tissue were evaluated using the ImageJ analysis program, and gray-scale histographic analysis values were generated. The FLHA rate was determined by dividing the fat tissue histographic value by the mass-lesion histographic value. Statistical analysis was performed using this value as well as the patients’ histopathologic data and BUS BI-RADS score. Results: A complementary effect was noted using FLHA rates with the BUS BI-RADS criteria, and a statistically significant difference was detected between benign and malignant histopathology groups ( P < .001). Similarly, the malignant histopathologic diagnosis with BI-RADS 4 and benign histopathologic diagnosis with BI-RADS 4 groups were related ( P < .001). The correlation between BI-RADS criteria and FLHA rates demonstrated a significant difference between BI-RADS 3 and BI-RADS 5 ( P < .001), and BI-RADS 4 and BI-RADS 5 for FLHA rates ( P = .002). Conclusion: It was determined that using the FLHA rate was a complement to the BUS BI-RADS criteria. In this cohort, there was a statistically significant difference in predicting possible malignancy in all BI-RADS classes.