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Purpose: Specimen sonography is necessary for successful surgical excision of non-palpable breast masses, discovered only in breast ultrasound. But is there any difference in echogenicity and echostructure between native and in vitro sonography? Methods: The ultrasound images from 46 benign and malignant breast tumors were documented under standardized conditions pre- and postoperative, using a linear array machine (Shimadzu, US device SDU-490) and 7.5 MHz transducer with a water path interposed between the transducer and skin or the plastic bag, containing the fresh specimens after surgical excision. Two images of each tumor were documented on a 3/4 in. Sony high-band video device (U-matic BVU-800-P), and the recordings were digitized with an 8-bit resolution in 384 × 288 pixels (frame grabber band, Ing. Büro Fa. Fricke, Berlin). In each sonographic image, the maximum area of the region of interest of the tumor was marked and then subjected to consecutive texture analysis and correlation to the histological findings. For evaluation of tumor status eight parameters of first and second order texture statistics (grey level histogram, Fourier analysis, co-occurrence matrix) were applied. Results: In all cases, the mass was clearly identified on sonograms obtained in the operating room. Fibroadenomas (n = 11), fibrocystic diseases (n = 5) and ductal carcinomas (n = 26) showed comparable results in texture analysis. On the other hand, lobular carcinomas (n = 4) were clearly different in all parameters, in especially mean of grey level, homogeneity and contrast (P < 0.001 on the basis of Wilcoxon and Student's t-test). Conclusions: In vitro examination is a rapid and efficient method of localizing impalpable breast masses in excised specimens, but differences in echostructure and echogenicity are possible. [ABSTRACT FROM AUTHOR]