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Galactoceles Mimicking Suspicious Solid Masses on Sonography

Department of Diagnostic Radiology, Research Institute of Radiological Science (M.J.K., E.-K.K., S.Y.P., H.K.J., K.K.O.), and Department of Pathology (J.Y.S.), Yonsei University College of Medicine, Seoul, Korea.

Address correspondence to Eun-Kyung Kim, MD, Department of Diagnostic Radiology, Yonsei University College of Medicine, Seodaemun-ku Shinchon-dong 134, Seoul 120-752, Korea. E-mail: ekkim{at}yumc.yonsei.ac.kr

Objective. The purpose of this study was to evaluate the sonographic appearance of a galactocele that can sonographically mimic a suspicious solid mass and to differentiate between a galactocele and a solid mass. Methods. From September 2002 to February 2004, 33 galactoceles classified as Breast Imaging Reporting and Data System category 4 were included. They were all confirmed by sonographically guided core biopsies. Their sonographic imaging and clinical findings were reviewed retrospectively. Results. The lesions had a round or irregular shape in 26 patients (78.8%), a noncircumscribed margin in 31 (93.9%), a nonparallel orientation in 22 (66%), and posterior shadowing in 13 (39.4%). Twenty-five nodules (75.8%) had internal hypoechogenicity or mixed echogenicity. Twenty-nine (87.9%) of 33 lesions showed a relatively sharp convex echogenic rim on the anterior or posterior wall. Conclusions. Galactoceles have various sonographic findings, many of which are similar to those of suspicious solid breast masses. However, there is a tendency for a galactocele to appear as a small, round hypoechoic nodule with an indistinct or microlobulated margin and mild posterior shadowing. It is helpful to search for a partial anterior or posterior echogenic rim to identify a galactocele.

Key Words: breast abnormalities • breast neoplasm • breast sonography

Abbreviations: BI-RADS, Breast Imaging Reporting and Data System

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