A spiculated mass is a cluster of barbed tissue that is one of the primary indicators of cancer. Rather than a smooth lump, it has spicules or thin, elongated pieces of tissue sticking out from its perimeter. These spiky tumors can appear anywhere inside the body, but are often found in the breasts or lungs. When found, these masses are typically biopsied to confirm whether they are malignant or benign. If cancerous, treatment ranging from excision to radiation can be used.
Of all the indications of cancer, which include calcified tissue, lesions and smooth masses, the spiculated mass is believed to have the highest incidence of malignancy. For breast cancer cases, one explanation for this might be that cell tissue in these masses has abnormally higher levels of progesterone and estrogen. Some studies have shown that a spiculated mass typically has at least 30 percent more progesterone receptors and estrogen receptors than normal breast tissue or non-spiculated lumps.
While usually cancerous, it is possible in rare cases for a spiculated mass to be benign, particularly in instances where there is scar tissue, granular tumors or the presence of foreign matter in the body. When present, these masses can appear singly or in multiples. Often, they occur with adjacent calcified tissue.
In cases of breast cancer, a spiculated mass usually exists on the periphery of the breast, not the center, and is typically discovered through ultrasonography or a mammogram, which is a screening that uses radiation to create images of breast tissue. A radiologist is able to use computer-aided diagnosis (CAD) software to magnify and highlight abnormalities in breast images with colored lines in order to evaluate whether a mass is spiculated. Spicules are difficult to discern. For lung cancer cases, a computerized tomography (CT) chest scan or magnetic resonance imaging (MRI) can detect a spiculated mass. In conjunction with those procedures, an invasive surgical screening of the chest known as mediastinoscopy might be used.
No other symptoms may accompany the presence of spiculated masses. Sometimes, however, pain, skin thickening and infection can be present. For some breast cancer patients, the inversion of nipples may accompany the presence of a mass of this kind. Smokers and people with cancer history in their families have a higher risk of suffering from spiculated masses.
Treatment for this type of mass located in the breast often includes lumpectomy or mastectomy. Radiotherapy and chemotherapy can be used for both breast and lung masses. Doctors often recommend lifestyle alterations, as well, such as abstinence from alcohol and smoking.
Can Spiculated Mass be Benign?
Breast cancer research shows that benign or malignant processes cause spiculated mass. Thus, tuberculosis, ductal carcinoma, and radial scar are the leading causes of spiculated mass. For instance, a study conducted in East Sussex indicates that about 4% of spiculated masses are benign.
Spiculated masses are often associated with malignancy. Differential diagnosis shows that malignancy has a high predictive value of 90%. If you have spiculated mass, there are higher chances it could be malignant.
Spicules represent several tumor cells in malignant lesions. However, spiculated mass caused by malignancy and benign has no difference in survival rate. In the lungs, round nodules are more likely benign, while irregularly shaped nodules are cancerous.
Benign nodules do not spread to local structures. Instead, they grow slowly and have unique borders. Benign nodules in the lungs are not mostly problematic but lead to extreme pain and other complications when they become significant.
The spiculation sign differentiates benign nodules and malignant ones. The spiculation sign extends from the pulmonary nodule to the pulmonary parenchyma. Diagnosis of benign nodules and malignant nodules are categorized into biopsy and imaging detection.
A biopsy is the most accurate way of detecting benign and malignant. In addition, a biopsy is a primary method of checking the trend of benign nodules from imaging. The doctor must collect samples of suspected spiculated mass in your lungs before a biopsy, and the doctor should check the suspected section in your lungs.
A biopsy is currently considered the standard for judging the presence of a spiculating mass in the breasts or lungs. Remember that doctors don’t need to do biopsies on all malignant nodules. Spiculation signs and cavity signs are the primary imaging features.
Unfortunately, biopsies don’t detect the development of nodules. Instead, it only shows the current benign and malignant spiculated masses. Modern computer imaging technology enables doctors to successfully detect if the spiculated mass is benign or malignant.
What Type of Breast Cancer is Spiculated?
Scientists believe that spiculated mass is common with luminal. Luminal is an invasive type of cancer with low protein levels, which controls how cancer spreads in the body. Luminal A breast cancer has a slower growth rate than other cancers. The difference between Luminal A and typical breast cancer is that normal breast cancer is higher grade.
However, both types of breast cancers have a good prognosis. Patients have five years of survival when diagnosed with either Luminal A or Luminal B type. Managing breast cancer subtypes is overwhelming, and the survival rate is lower at 50%.
If diagnosed with Luminal A breast cancer, you need surgery to remove the tumors through a mastectomy or a lumpectomy. Your surgeon will know which will yield the best outcomes, and reconstructive surgery is usually possible.
How is Spiculation Characterized in Ultrasound Lesions?
The existence of spiculation is crucial when characterizing malignant tumors.
There are multiple mammographic methods used to detect a spiculated mass. It’s hard to see spiculation tumors with traditional two-dimensional ultrasound, as the spiculation mass will only appear parallel to the skin in this method.
Recently, medical engineers developed a three-dimensional ultrasound that helps determine the architectural distortion surrounding a breast tumor.
Does Spiculated Mass Always Mean Cancer?
Different types of cancer appear spiculated because of a previous invasion into the nearby tissue. It can also result from a desmoplastic reaction in the breast tissues. For instance, spiculated breast lesions can be differentiated in morphologic characteristics.
In benign cases, the leading causes of spiculation mass are fibrous tissues and lipid-filled spaces. Spiculation in malignant instances is caused by the desmoplastic response and excessive tumor inflation. Mammography is not a reliable method of diagnosing benign and malignant spicules. Patients must undergo frequent breast examination and surgical biopsy.
Radiolucent lines are a clear sign of benign etiology. It’s hard to differentiate spiculated lesions from carcinoma, especially when using the standard mammographic feature. In most cases, radiolucent lines in benign are 86.7 percent, while specificity stands at 61.5 percent.
Parting Shot
No doubt spiculated masses are the leading signs of cancer. However, not all spiculated masses are malignant, and at least 10% of spiculated masses are benign. Biopsy and other latest medical technologies detect if the spiculated mass is benign or malignant.