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. 2016 Apr;11(2):123-7.
doi: 10.1159/000444377. Epub 2016 Mar 23.

Differentiation between Phyllodes Tumors and Fibroadenomas Based on Mammographic Sonographic and MRI Features

Lale Duman  1 , Naciye S Gezer  1 , Pınar Balcı  1 , Canan Altay  1 , Işıl Başara  1 , Merih G Durak  2 , Ali I Sevinç  3
Affiliations

Differentiation between Phyllodes Tumors and Fibroadenomas Based on Mammographic Sonographic and MRI Features

Lale Duman et al. Breast Care (Basel). 2016 Apr.

Abstract

Background: This study was performed to compare the mammographic, sonographic, and magnetic resonance imaging (MRI) characteristics of phyllodes tumors and fibroadenomas, which may resemble each other.

Methods: Preoperative mammograms, B-mode and Doppler sonograms, and dynamic breast MRIs of 72 patients with pathologically proven fibroadenomas and 70 patients with pathologically proven phyllodes tumor were evaluated in this retrospective study. Statistical significance was evaluated using chi-square and Fisher's exact tests. Correlations in lesion size among radiological methods were examined by Pearson's correlation analysis.

Results: The features that differed on mammogram were size, shape, and margin of the mass. Sonograms showed significant differences in size, shape, margin, echo pattern, and vascularization of the mass. Pearson's correlation analysis showed strong agreement among radiological methods in terms of assessment of size. Tumor size ≥ 3 cm, irregular shape, microlobulated margins, complex internal echo pattern, and hypervascularity were significant findings of phyllodes tumors. Internal cystic areas on MRI were frequently associated with phyllodes tumors.

Conclusion: Mammographic, sonographic, and MRI findings of fibroadenomas and phyllodes tumors could help radiologists to ascertain imaging-histological concordance and guide clinicians in their decision making regarding adequate follow-up or the necessity of biopsy.

Keywords: Differential diagnosis; Fibroadenoma; Phyllodes tumor.

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Figures

Fig. 1
Fig. 1
a Mammogram of a 49-year-old woman indicating an irregular mass with partially indistinct margins. b Sonogram showed an oval-shaped hypoechoic mass with microlobulated margins and heterogeneous internal echogenicity. Histopathology indicated a benign phyllodes tumor.
Fig. 2
Fig. 2
Mediolateral oblique view mammogram of a 44-year-old woman indicating a lobulated hyperdense mass with microlobulated margins. Distortion of the surrounding parenchyma and skin edema were also shown. Histopathology indicated a malignant phyllodes tumor.
See this image and copyright information in PMC

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