Differentiation between phyllodes tumor and fibroadenoma using real-time elastography.

PURPOSE

Phyllodes tumors (PT) are a rare entity accounting for less than 1 % of all breast lesions. They have a malignancy rate of 25-30%. Differentiation from benign fibroadenomas is difficult using ultrasound, mammogram and MRI. The elastic characteristics of both tumors were examined using real-time elastography (RTE) to find specific patterns that make differentiation possible.

MATERIALS AND METHODS

From February 2007 to May 2009, a total of 620 women were examined by RTE. Histological diagnosis was achieved using core needle biopsy. 123 of the lesions were fibroadenomas, 8 were phyllodes tumors. All patients underwent mammography and ultrasound followed by RTE. Sonography was performed by Acuson Antares, Premium Edition® (Siemens, Erlangen, Germany) with a 7 and 10 MHz transducer.

RESULTS

All phyllodes tumors had a similar elastic pattern with an elastic center and inelastic outer limits, referred to as the "ring sign". It was found in 5% of all fibroadenomas.

CONCLUSION

RTE provides a specific elastic pattern, which is sufficient for differentiating between a fibroadenoma and a phyllodes tumor. Therefore, the detection of the most suspicious lesion in women with the coexistence of multiple fibroadenomas and phyllodes tumors seems easier.