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01-06-2009 | Breast

Appearence of breast masses on sonoelastography with special focus on the diagnosis of fibroadenomas

Authors: Eduardo F. C. Fleury, Jose F Rinaldi, Sebastiao Piato, Jose Carlos V. Fleury, Decio Roveda Junior

Published in: European Radiology | Issue 6/2009

Abstract

The aim of this study was to show and correlate the imaging features of breast masses, especially fibroadenomas, using sonoelastography. Two hundred thirty-five patients with 302 breast lesions referred for core needle biopsy participated in the study. All lesions appearing as solid masses on conventional US were included. Out of the included lesions (270), 115 (42.6%) corresponded to histologically confirmed fibroadenomas and 155 (57.4%) to lesions with histologically confirmed diagnoses other than fibroadenomas. These were further subdivided into fibrocystic changes, lesions with low malignancy potential, and malignant lesions. Fibroadenomas were also divided according to histological presentation into three subgroups to allow comparative study based on elastographic scores. All lesions were classified using a four-point scoring system based on ultrasound elastography imaging characteristics. Different presentations were observed for elastographic scores according to histological presentation of fibroadenomas, whereby fibroadenomas with benign characteristics tended to have elastographic classification similar to fibrocystic changes, and complex and hypercellular fibroadenomas had classifications similar to harder lesions. Fibroadenomas are generally classified as category 3 in the BI-RADS® lexicon and are the most commonly found lesions in breast biopsies. Sonoelastography can provide additional information to conventional studies and be used as an auxiliary tool in assessing these masses in clinical practice.

Stavros AT, Thickman D, Rapp CL, Dennis MA, Parker SH, Sisney GA (1995) Solid breast nodules: use of sonography to distinguish between benign and malignant lesions. Radiology 196(1):14–15

Sickles EA (1994) Management of probably benign lesions of the breast. Radiology 193(2):582–583PubMed

Kolb TM, Lichy J, Newhouse JH (1998) Occult cancer in women with dense breasts: detection with screening US–diagnostic yield and tumor characteristics. Radiology 207(1):191–199PubMed

Norton LW, Zeligman BE, Pearlman NW (1988) Accuracy and cost of needle localization breast biopsy. Arch Surg 123(8):947–950PubMed

Brenner RJ, Sickles EA (1989) Acceptability of periodic follow-up as an alternative to biopsy for mammographically detected lesions interpreted as probably benign. Radiology 171(3):645–646PubMed

Kolb TM, Lichy J, Newhouse JH (2002) Comparison of the performance of screening mammography, physical examination, and breast US and evaluation of factors that influence them: an analysis of 27,825 patient evaluations. Radiology 225(1):165–175PubMedCrossRef

Gordon PB, Gagnon FA, Lanzkowsky L (2003) Solid breast masses diagnosed as fibroadenoma at fine-needle aspiration biopsy: acceptable rates of growth at long-term follow-up. Radiology 229(1):233–238PubMedCrossRef

Rubin E (1999) Six-month follow-up: an alternative view. Radiology 213:15–18PubMed

Graf O, Helbich TH, Hopf G, Graf C, Sickles EA (2007) Probably benign breast masses at US: is follow-up an acceptable alternative to biopsy? Radiology 244(1):87–93PubMedCrossRef

10.

Costantini M, Belli P, Lombardi R, Franceschini G, Mulè A, Bonomo L (2006) Characterization of solid breast masses: use of the sonographic breast imaging reporting and data system lexicon. J Ultrasound Med 25(5):649–659PubMed

11.

Zonderland HM, Pope TL Jr, Nieborg AJ (2004) The positive predictive value of the breast imaging reporting and data system (BI-RADS) as a method of quality assessment in breast imaging in a hospital population. Eur Radiol 14(10):1743–1750PubMedCrossRef

12.

Kim EK, Ko KH, Oh KK, Kwak JY, You JK, Kim MJ, Park BW (2008) Clinical application of the BI-RADS final assesment to breast sonography in conjunction with mammography. AJR Am J Roentgenol 190(5):1209–1215PubMedCrossRef

13.

Hong AS, Rosen EL, Soo MS, Baker JA (2005) BI-RADS for sonography: positive and negative predictive values of sonographic features. AJR Am J Roentgenol 184(4):1260–1265PubMed

14.

Tohno E, Ueno E (2008) Current improvements in breast ultrasound, with a special focus on elastography. Breast Cancer 15(3):200–204PubMedCrossRef

15.

Scaperrotta G, Ferranti C, Costa C, Mariani L, Marchesini M, Suman L, Folini C, Bergonzi S (2008) Role of sonoelastography in non-palpable breast lesions. Eur Radiol 18(11):2831–2839CrossRef

16.

Goel NB, Knight TE, Pandey S, Riddick-Young M, Paredes ES, Trivedi A (2005) Fibrous lesions of the breast: imaging-pathologic correlation. RadioGraphics 25(6):1547–1559PubMedCrossRef

17.

Gokalp G, Topal U, Kizilkaya E (2008) Power Doppler sonography: Anything to add to BI-RADS US in solid breast masses? Eur J Radiol. doi:10.1016/j.ejrad.2007.12.007

18.

Weinstein D, Strano S, Cohen P, Fields S, Gomori JM, Degani H (1999) Breast fibroadenoma: mapping of pathophysiologic features with three-time-point, contrast-enhanced mr imaging—pilot study. Radiology 210(1):233–240PubMed

19.

Fornage BD, Lorigan JG, Andry E (1989) Fibroadenoma of the breast: sonographic appearance. Radiology 172(3):671–675PubMed

20.

Fleury EFC, Rinaldi JFR, Piato S, Fleury JCV, Roveda JRD (2008) Features of cystic breast lesions at ultrasound elastography. Radiol Bras 41(3):167–172CrossRef

21.

Youden D (1950) Index for rating diagnostic tests. Cancer 3:32–35PubMedCrossRef

22.

Kaplan SS (2001) Clinical utility of bilateral whole-breast us in the evaluation of women with dense breast tissue. Radiology 221(3):641–649PubMedCrossRef

23.

Roveda Junior D, Piato S, Oliveira VM, Ferreira CAP, Fleury ECF (2007) Valores preditivos das categorias 3, 4 e 5 do sistema BI-RADS em lesões mamárias nodulares não-palpáveis avaliadas por mamografia, ultra-sonografia e ressonância magnética. Radiol Bras 40(2):93–98CrossRef

24.

Lazarus E, Mainiero MB, Schepps B, Koelliker SL, Livingston LS (2006) BI-RADS lexicon for US and mammography: interobserver variability and positive predictive value. Radiology 239(2):385–391PubMedCrossRef

25.

Sickles EA (1999) Probably benign breast lesions: when should follow-up be recommended and what is the optimal follow-up protocol? Radiology 213(1):11–14PubMed

26.

Stavros AT, Thickman D, Rapp CL, Dennis MA, Parker SH, Sisney GA (1995) Solid breast nodules: use of sonography to distinguish between benign and malignant lesions. Radiology 196(1):123–134 1995PubMed

27.

Mainiero MB, Goldkamp A, Lazarus E, Livingston L, Koelliker SL, Schepps B, Mayo-Smith WW (2005) Characterization of breast masses with sonography: can biopsy of some solid masses be deferred? J Ultrasound Med 24(2):161–167PubMed

28.

Ophir J, Cespedes I, Ponnekanti H, Yazdi Y, Li X (1991) Elastography: a quantitative method for imaging the elasticity of biological tissues. Ultrason Imaging 13(2):111–134PubMedCrossRef

29.

Hoyt K, Forsberg F, Ophir J (2006) Analysis of a hybrid spectral strain estimation technique in elastography. Phys Med Biol 51(2):197–209PubMedCrossRef

30.

Itoh A, Ueno E, Tohno E, Kamma H, Takahashi H, Shiina T, Yamakawa M, Matsumura T (2006) Breast disease: clinical application of US elastography for diagnosis. Radiology 238(2):341–350CrossRef

Title: Appearence of breast masses on sonoelastography with special focus on the diagnosis of fibroadenomas
Authors: Eduardo F. C. Fleury
Jose F Rinaldi
Sebastiao Piato
Jose Carlos V. Fleury
Decio Roveda Junior
Publication date: 01-06-2009
Publisher: Springer-Verlag
Published in: European Radiology / Issue 6/2009
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-008-1285-2

At a glance: The STEP trials

Springer Medicine

Appearence of breast masses on sonoelastography with special focus on the diagnosis of fibroadenomas

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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