ultrasound terms

[Montana girl 06]

I have a history of calcifications (3 benign biopsies) and fibrocystic breasts. On a recent ultrasound the report states: There is a rounded heterogeneous lesion with multiple high echoes within it measuring 1.8x1.7x1.6 cm ... There is no flow within this lesion seen on color Doppler imaging. There is a slight decrease in measurement, however, this may be secondary to intraobserver variability. Recommend 6-month interval ultrasound to determine stability. (Previous ultrasound stated they suspected the lesion was a galactocele. Also, inbetween ultrasounds the lesion grew to about 5 cm. and then started shrinking by MY observation.)

Can anyone help with terminology? What does multiple high echoes imply?  No flow is a good thing, right? Also, does intraobserver variability refer to the difference in how it was read by two different people?

Thanks for any help you can give.

[BhumikaMD]

Hi,
Yes, an infective pathology would mean an infection.
As you mention that the lesion has started to heal, and even our doctor has advised a follw up in 6 months time - it just implies that it goes more in favour of infection than cancer.
A re evaluation at the end of  4-6 months or in case you notice any abnormal featue on self breast examination would be the most advisable management plan.
Hope this helps.
Good luc.

[Montana girl 06]

Thanks so much for your help. Could you clarify what you meant by "infective pathology?" Is this possibly an infection rather than being suspicious for cancer?

[BhumikaMD]

Hi,
On ultrasound, sound waves are used to project an image on film.  Lesions can be either hypo echoic (darker) or hyper echoic (brighter).  An ultrasound cannot differentiate between cancerous and non-cancerous lesions. It can only tell whether they are solid or cystic (fluid filled). A hyper echoic lesion is generally whiter than the surrounding breast tissue and clinical evaluation and further investigation is required to come to a definite diagnosis. Bit as you say, the lesion is regressing in your case, it could be an infective pathology and you need to get a review in 6 months time as suggested.
No flows during color doppler mean that the lesion is not vascular.
Yes, itraobserver variability does mean the difference in tnterpretation when two people are reading the ultrasound.
Hope this helps.
Good luck.