Predictive sonographic features for differentiation of breast fibroepithelial tumors: fibroadenoma versus phyllodes tumor

Abstract

Fibroepithelial tumors (FETs) of the breast are benign tumors, which include fibroadenoma (FA) and phyllodes tumor (PT). Although they show different biological behaviors, differentiation using imaging features or core needle biopsy is challenging. Therefore, we evaluated sonographic features that could be useful for differentiating FA and PT and the diagnostic accuracy of core needle biopsy for differentiating breast FETs. MethodsA total of 121 patients with 125 lesions diagnosed as fibroepithelial tumors on US-guided core needle biopsy from March 2017 to April 2020 were studied. Among them, sonographic features of 68 lesions were analyzed retrospectively. Clinicopathologic results of core needle biopsy and surgical excision were reviewed using electronic medical records. ResultsTumor size, echogenicity, presence of an internal cleft, vascularity, and elasticity showed significant differences between FA and PT. A large tumor size (≥3 cm), presence of an internal cleft, and hard elasticity were common sonographic features in PTs. Core needle biopsy revealed similar pathologic results with surgical excision performed in 61 cases of 68 cases (89%). ConclusionUltrasonographic features can be useful imaging factors for differentiating FA and PT. Moreover, US-guided core needle biopsy can replace surgical excision with a high diagnostic accuracy in some cases.