Radiological and clinical findings in sclerosing adenosis of the breast

Abstract

To study the imaging and clinical features of breast sclerosing adenosis (SA), and to enhance the recognition of this disease, as well as to help the clinic to give a correct diagnosis.Imaging findings were retrospectively reviewed in 47 women with SA lesions confirmed by pathology (including 39 cases of mammography, 40 cases of ultrasound [US], and 34 cases magnetic resonance imaging [MRI]).Of 47 patients confirmed with SA, 18 cases were pure SA, and 29 cases coexist with other proliferative lesions and malignancies; the maximum diameter of SA lesions was 0.5 to 3.5 cm with an average of 1.6 cm. On the mammogram of 39 SA cases, the percentage of architectural distortion, calcifications, mass/nodular, asymmetric density, and mass combining with calcifications were 30.8%, 23.1%, 17.9%, 12.8%, and 7.7%, respectively; and 3 cases had no abnormal findings. On the sonogram (excluding 5 normal finding cases), the majority of lesions showed regular shaped (57.1%), well defined margined (60.0%), heterogenous low echoed (71.4%) nodulus. 85.3% lesions showed high signal on T2-weighted images, and all lesions were enhanced markedly, including 82.4% lesions appearing mass-like enhancement (17 star-shaped enhanced masses included); and the percentage of the time-signal intensity curve in type 1, type 2, and type 3 were 52.9%, 41.2%, and 5.9%, respectively. If the category breast imaging-reporting and data system ≥4b was considered to be a suspicious malignant lesion, the misdiagnostic rates of mammography, US, and MRI would be 17.9%, 17.5%, and 35.3%, respectively.The SA lesions are small and can occur with other diseases histologically. The majority of SA lesions showed distortion or calcifications on mammograms, low echo-level nodules with heterogenous echo on US and mass-like lesion with or without star shape on enhanced MRI.

Ultrasound‐Based Nomogram for Distinguishing Malignant Tumors from Nodular Sclerosing Adenoses in Solid Breast Lesions

“…Our nomogram is different from the traditional BI‐RADS categorization scheme. Previous studies could not differentiate NSA and MT through ultrasonic features and BI‐RADS category 28,29 . One study has shown that the US BI‐RADS atlas together with breast elastography may be a powerful tool to identify NSA and differentiate it from breast cancer 25 .…”

Cytological diagnosis of sclerosing adenosis of breast: Diagnostic challenges and literature review

“…Moreover, radiological features are also variable ranging from architectural disorder on mammograms to a well-defined heterogenous low echogenicity nodule on ultrasound or a small star-shaped enhanced mass on magnetic resonance imaging. 4 The mammographic pattern of SA with microcalcifications may sometimes raise suspicion of a carcinoma. In our case, acinar (Figure 2A) and tubular structures (Figures 1B and 3A) were distinctive features.…”

Breast Imaging for Non-radiologists

“…Sclerosing adenosis is a benign, usually asymptomatic lobulocentric proliferative process that involves both the epithelial and the mesenchymal components. The majority show distortion or calcifications on mammograms, heterogenous hypoechogenic nodules on US, and mass-like lesions on enhanced MRI (27).…”