Sonographic and Mammographic Features of Different Echogenic Breast Lesions: A Pictorial Essay

iNtRODUCtiON Ultrasonography is useful in the evaluation of clinically and mammographically detected breast masses. It is particularly useful in dense breasts that are more common in Asian women than in Caucasian women. According to the ACR BI-RADS Atlas (2013), hyperechogenicity is defined as having increased echogenicity relative to fat or equal to fibroglandular tissue.1 This pictorial essay reviews breast lesions that are hyperechoic or heterogeneous with hyperechoic components on ultrasonography. Imaging features are highlighted to help differentiate between different echogenic lesions, and additional sonographic features that warrant biopsy. Benign and malignant lesions with pathological proof are shown with imaging and causes of echogenic appearance of breast lesions; their diagnosis, investigation and management are discussed.