An Evaluation of Ultrasound Features of Breast Fibroadenoma

Authors

Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Breast cancer is among the most common cancers in the world. Ultrasound evaluations of breast have come into attention as an alternative route. Ultrasound features of benign lesions such as fibroadenoma can be overlapping with those in a malignant tumor. Here, we assessed the reports of breast ultrasound in patients with pathologic diagnosis of fibroadenoma. Materials and Methods: We conducted a cross-sectional study and enrolled female patients with confirmed histologic diagnosis of fibroadenoma. Ultrasound studies were performed on the participants to see which sonographic patterns are more frequent in such lesions. Results: In 92 patients with 40.4 ± 9.2 years of age, all participants were classified as stage 4 on Breast Imaging-Reporting and Data System scale. The mean ± standard deviation of size for the lesions was 167.4 ± 101.4 mm2. Upper outer quadrants in the breasts had the most number of lesions. Almost lesions were round with only 2.2% were oval. When assessed for the margin definition, 57.8% were circumscribed. Noncircumscribed masses were reported in 21.7%. About 91.3% of cases were hypoechoic in the ultrasound evaluation. Lobulated masses were in 28.3% of the cases. 8.7% of the masses were spongy whereas 9.8% and 2.2% of them had calcification and heterogenic appearance, respectively. Conclusion: The most frequent features include a hypoechoic mass with a circumscribed border; however, complex presentations that overlap malignant masses are also detectable including noncircumscribed margin, lobulation, presence of a posterior shadow, heterogenicity, and micro calcification.

Keywords

1.
Malur S, Wurdinger S, Moritz A, Michels W, Schneider A. Comparison of written reports of mammography, sonography and magnetic resonance mammography for preoperative evaluation of breast lesions, with special emphasis on magnetic resonance mammography. Breast Cancer Res 2001;3:55-60.  Back to cited text no. 1
[PUBMED]    
2.
Devolli-Disha E, Manxhuka-Kërliu S, Ymeri H, Kutllovci A. Comparative accuracy of mammography and ultrasound in women with breast symptoms according to age and breast density. Bosn J Basic Med Sci 2009;9:131-6.  Back to cited text no. 2
    
3.
Borecky N, Rickard M. Preoperative diagnosis of carcinoma within fibroadenoma on screening mammograms. J Med Imaging Radiat Oncol 2008;52:64-7.  Back to cited text no. 3
[PUBMED]    
4.
Berg WA, Blume JD, Cormack JB, Mendelson EB, Lehrer D, Böhm-Vélez M, et al. Combined screening with ultrasound and mammography vs mammography alone in women at elevated risk of breast cancer. JAMA 2008;299:2151-63.  Back to cited text no. 4
    
5.
Pengelly S, Lambert AW, Khan M, Groome J. Breast lumps in service women. J R Nav Med Serv 2014;100:174-8.  Back to cited text no. 5
[PUBMED]    
6.
Houssami N, Cheung MN, Dixon JM. Fibroadenoma of the breast. Med J Aust 2001;174:185-8.  Back to cited text no. 6
[PUBMED]    
7.
Prasad SN, Houserkova D. A comparison of mammography and ultrasonography in the evaluation of breast masses. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2007;151:315-22.  Back to cited text no. 7
[PUBMED]    
8.
Elverici E, Zengin B, Nurdan Barca A, Didem Yilmaz P, Alimli A, Araz L. Interobserver and intraobserver agreement of sonographic BIRADS lexicon in the assessment of breast masses. Iran J Radiol 2013;10:122-7.  Back to cited text no. 8
[PUBMED]    
9.
Rjosk-Dendorfer D, Reu S, Deak Z, Hetterich H, Kolben T, Reiser M, et al. High resolution compression elastography and color doppler sonography in characterization of breast fibroadenoma. Clin Hemorheol Microcirc 2014;58:115-25.  Back to cited text no. 9
[PUBMED]    
10.
Fornage BD, Lorigan JG, Andry E. Fibroadenoma of the breast: Sonographic appearance. Radiology 1989;172:671-5.  Back to cited text no. 10
[PUBMED]    
11.
Jackson VP, Rothschild PA, Kreipke DL, Mail JT, Holden RW. The spectrum of sonographic findings of fibroadenoma of the breast. Invest Radiol 1986;21:34-40.  Back to cited text no. 11
[PUBMED]    
12.
Smith GE, Burrows P. Ultrasound diagnosis of fibroadenoma – Is biopsy always necessary? Clin Radiol 2008;63:511-5.  Back to cited text no. 12
[PUBMED]    
13.
Liu H, Yeh ML, Lin KJ, Huang CK, Hung CM, Chen YS. Bloody nipple discharge in an adolescent girl: Unusual presentation of juvenile fibroadenoma. Pediatr Neonatol 2010;51:190-2.  Back to cited text no. 13
[PUBMED]    
14.
Arora R, Abou-Bakr A, Al Taleb A. Fine needle aspiration diagnosis of a spontaneously infarcted fibroadenoma mimicking carcinoma: A case report. Anal Quant Cytopathol Histpathol 2013;35:57-60.  Back to cited text no. 14
[PUBMED]    
15.
Shi A, Li S, Xu N, Nie G, Li X, Zhang T, et al. Clinical features and prognosis of a unilateral fibroadenoma of the breast in a 16-month-old female. Jpn J Clin Oncol 2011;41:260-4.  Back to cited text no. 15
[PUBMED]    
16.
Wirtzfeld LA, Nam K, Labyed Y, Ghoshal G, Haak A, Sen-Gupta E, et al. Techniques and evaluation from a cross-platform imaging comparison of quantitative ultrasound parameters in an in vivo rodent fibroadenoma model. IEEE Trans Ultrason Ferroelectr Freq Control 2013;60:1386-400.  Back to cited text no. 16
[PUBMED]    
17.
Limite G, Esposito E, Sollazzo V, Ciancia G, Formisano C, Di Micco R, et al. Lobular intraepithelial neoplasia arising within breast fibroadenoma. BMC Res Notes 2013;6:267.  Back to cited text no. 17
[PUBMED]    
18.
Zaitsev AN, Vesnin AG, Semiglazov VF, Orlov AA, Chernomordikova MF, Chebykin IA, et al. Ultrasound differentiation of fibroadenoma and diagnosis of minimal carcinoma of the breast. Vopr Onkol 1998;44:198-202.  Back to cited text no. 18
    
19.
Asirvatham JR, Shah A, Carreon CK, Bhuiya TA, Kahn LB, Kostroff K, et al. Ossifying fibromyxoid tumor of the breast mimicking fibroadenoma: A case report and differential diagnoses. Arch Pathol Lab Med 2014;138:1098-100.  Back to cited text no. 19
[PUBMED]    
20.
Gatta G, Iaselli F, Parlato V, Di Grezia G, Grassi R, Rotondo A. Differential diagnosis between fibroadenoma, giant fibroadenoma and phyllodes tumour: Sonographic features and core needle biopsy. Radiol Med 2011;116:905-18.  Back to cited text no. 20
[PUBMED