Journal of Medical Ultrasonicshttp5/doi.org/10.1007/s10396-023-01308-9SPECIAL FEATURE:REVIEW ARTICLEUltrasound diagnosis of breast non-mass abnormalities Including diagnosis with othermodalitiesThe Japan Society of Ultrasonics in Medicine guidelines on non-massabnormalities of the breastToshikazu Ito1.Ei Ueno2.Tokiko Endo3.Kiyoka Omoto4.Akira Kuwajima5.Nobuyuki Taniguchi5.Hiroko Tsunoda.Eriko Tohno2.Hideyuki Hashimoto.Yasuhisa Fujimoto.Takanori Watanabe10Received:1 March 2023/Accepted:4 April 2023e The Author(s)2023AbstractIt is possible to appropriately diagnose non-mass abnormalities by elucidating ultrasound non-mass abnormality findingsand sharing the concept.If non-mass abnormalities can be diagnosed early,the number of curable cases could increase,lead-ing to fewer breast cancer deaths.The Japan Society of Ultrasonics in Medicine (JSUM)Terminology/Diagnostic CriteriaCommittee has classified non-mass abnormalities into five subtypes:hypoechoic area in the mammary gland,abnormalitiesof the ducts,architectural distortion,multiple small cysts,and echogenic foci without a hypoechoic area.We herein definethe findings for each of these subtypes and present a summary of the JSUM guidelines on non-mass abnormalities of thebreast generated based on those findings.Keywords Non-mass abnormalities.Breast ultrasound.Hypoechoic area.Abnormalities of the ducts.ArchitecturaldistortionIntroduction☒Toshikazu ItoWith respect to non-mass image-forming breast cancer ontoshiito@med.kindai.ac.jpbreast ultrasound (US),lesions that are difficult to recog-Division of Breast and Endocrine Surgery,Departmentnize began to be identified as masses presenting a variety ofof Surgery,Faculty of Medicine,Kindai University,Osaka,morphologies,including the visualization of breast cancerJapanwith abnormal nipple discharge as mammary duct dilata-3Tsukuba International Breast Clinic,Ibaraki,Japantion on US images in the 1980s [1,2].In addition,withDepartment of Breast Surgery,National Hospitalthe widespread adoption of mammography screening,manyOrganization Higashinagoya National Hospital,Aichi,Japancases of breast cancer showing microcalcifications are beingDepartment of Laboratory Medicine,Saitama Medicaldetected [3-6];the morphology has been identified by col-Center,Jichi Medical University,Saitama,Japanlating lesions on mammography images with US images,Department of Health Check-Up,PL Tokyo Health Controland it is now possible to detect the US image characteris-Center,Tokyo,Japantics of non-mass image-forming breast cancer [7.8].TheDepartment of Clinical Laboratory Medicine,Jichi Medicalsubsequent widespread adoption of US breast screening asUniversity.Tochigi,Japanwell as advances in diagnostic equipment have resulted inDepartment of Radiology,St.Luke's International Hospital,an increasing awareness of non-mass abnormalities [9-24].Tokyo,JapanThe Breast Imaging Reporting and Data System(BI-Medical Department,Chiba Foundation for HealthRADS)5th edition US lexicon includes mas
