Imaging and Management of Fibroepithelial Lesions of the Breast:                     Radiologic-Pathologic Correlation

Zhang, Meng; Arjmandi, Firouzeh K.; Porembka, Jessica H.; Seiler, Stephen J.; Goudreau, Sally H.; Merchant, Kanwal; Hwang, Helena; Hayes, Jody C.

doi:10.1148/rg.230051

Cited by 3 publications

(8 citation statements)

References 64 publications

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“…Ultrasound is the primary diagnostic tool, revealing a large, homogeneous, hypoechoic mass that may show hypervascularity on colour Doppler, with posterior acoustic enhancement. It tends to displace adjacent structures without invasion [ 2 ], which was found in our patient. In complex and hyalinized fibroadenomas, suspicious components maybe found such as irregular shape, non-circumscribed margins or microcalcifications.…”

Section: Discussionmentioning

confidence: 68%

“…FET include phyllodes tumors (PT) in their three forms (benign, borderline, and malignant), and adenofibromas as well as their variants (simple, complex, lactating, hyaline, myxoid, juvenile, and giant). They have a slow development, except for those that are hormonally sensitive, such as juvenile fibroadenomas, lactating fibroadenomas, and PT [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

“…When performed, it appears as a well-defined, oval-shaped opacity, measuring more than 5 cm. Variants of fibroadenoma may appear hypodense, containing fat or a fluid-fluid level, as well as calcifications (especially in complex and hyaline forms) or having lobulated contours [ 2 ]. Ultrasound is the primary diagnostic tool, revealing a large, homogeneous, hypoechoic mass that may show hypervascularity on colour Doppler, with posterior acoustic enhancement.…”

Section: Discussionmentioning

confidence: 99%

“…The presence of non-enhancing septa is found in more than 50 % of cases, but is not specific and could be found in fibroadenoma variant but also PT, making the differential diagnosis more challenging. Moreover, Myxoid FAs, specifically, can have overlapping MRI features with those of mucinous carcinomas of the breast, such as irregular margin, rapid enhancement and wash out [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

“…These different types may have similar radiological appearances, and histopathological examination allows for their differentiation, although they can pose a diagnostic challenge for the pathologist due to lesion heterogeneity. It is essential to know the true nature of the epithelial lesion to avoid missing a borderline or malignant form with metastatic potential [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

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Giant juvenile fibroadenoma: A case report

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

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Giant juvenile fibroadenoma: A case report

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Tumeurs fibroépithéliales, du diagnostic au suivi

Geffroy,

Kerdraon,

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Case report: Possible role of low-dose PEM for avoiding unneeded procedures associated with false-positive or equivocal breast MRI results

Rapley,

Freitas,

Weinberg

et al. 2024

Front. Oncol.

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Contrast-enhanced breast magnetic resonance imaging (MRI) is currently recommended as a screening tool for high-risk women and has been advocated for women with radiologically dense breast tissue. While breast MRI is acknowledged for its high sensitivity (with an exception for lower-grade ductal carcinoma in situ (DCIS) where emerging techniques like diffusion-weighted imaging offer improvement), its limitations include sensitivity to hormonal changes and a relatively high false-positive rate, potentially leading to overdiagnosis, increased imaging uncertainty, and unnecessary biopsies. These factors can exacerbate patient anxiety and impose additional costs. Molecular imaging with breast-targeted Positron Emission Tomography (PET) has shown the capability to detect malignancy independent of breast density and hormonal changes. Furthermore, breast-targeted PET has shown higher specificity when compared with MRI. However, traditional PET technology is associated with high radiation dose, which can limit its widespread use particularly in repeated studies or for undiagnosed patients. In this case report, we present a clinical application of low-dose breast imaging utilizing a breast-targeted PET camera (Radialis PET imager, Radialis Inc). The case involves a 33-year-old female patient who had multiple enhanced lesions detected on breast MRI after surgical removal of a malignant phyllodes tumor from the right breast. A benign core biopsy was obtained from the largest lesion seen in the left breast. One month after the MRI, 18F-fluorodeoxyglucose (18F-FDG) PET imaging session was performed using the Radialis PET Imager. Although the Radialis PET Imager has proven high count sensitivity and the capability to detect breast lesions with low metabolic activity (at a dose similar to mammography), no areas of increased 18F-FDG uptake were visualized in this particular case. The patient underwent a right-sided nipple-sparing mastectomy and left-sided lumpectomy, with bilateral reconstruction. The excised left breast tissue was completely benign, as suggested by both core biopsy and the PET results. The case presented highlights a promising clinical application of low-dose breast-targeted PET imaging to mitigate the uncertainty associated with MRI while keeping radiation doses within the safe range typically used in X-ray mammography.

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Imaging and Management of Fibroepithelial Lesions of the Breast: Radiologic-Pathologic Correlation

Cited by 3 publications

References 64 publications

Giant juvenile fibroadenoma: A case report

Giant juvenile fibroadenoma: A case report

Tumeurs fibroépithéliales, du diagnostic au suivi

Case report: Possible role of low-dose PEM for avoiding unneeded procedures associated with false-positive or equivocal breast MRI results

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