The Spectrum of Sonographic Findings of Fibroadenoma of the Breast

Jackson, Valerie P.; Rothschild, Peter; Kreipke, Donald L.; Mail, J T; Holden, Robert W.

doi:10.1097/00004424-198601000-00006

Cited by 68 publications

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“…However, attempts to correlate between the sonographic features of solid masses compatible with fibroadenomas and pathologic findings were disappointing. 30 There is some overlap in the sonographic criteria for fibroadenomas and for breast cancer, 31 and approximately 25% of fibroadenomas appear with irregular margins, which may imply that the lesions are malignant. 29 Also, only 82% of biopsy-proven fibroadenomas were visualized by sonography in one study.…”

Section: Sonographymentioning

confidence: 99%

Management of breast fibroadenomas

1998

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F ibroadenomas are common benign lesions of the breast that usually present as a single breast mass in young women. They are assumed to be aberrations of normal breast development or the product of hyperplastic processes, rather than true neoplasms. The clinician often faces the dilemma whether to remove the mass or to monitor it by means of periodic follow-up examinations. Although removal of these lesions is a definitive solution, surgery may involve unnecessary excisions of benign lesions and unbecoming cosmesis. Moreover, a policy of conducting surgery on all patients with fibroadenomas would place an enormous burden on health care systems. A balanced and rational approach to the management of a fibroadenoma of the breast needs to address the crucial questions about its association with breast cancer, especially whether or not it is a marker of increased risk of breast malignancy. Another consideration to be weighed is that a substantial percentage of these lesions undergo spontaneous regression. Herein, based on our review of the current data on fibroadenomas of the breast and our experience, we propose practical algorithms for their management. INCIDENCE AND RISK FACTORSThere are no clear-cut data on the incidence of fibroadenomas in the general population. In one study, the rate of occurrence of fibroadenomas in women who were examined in breast clinics was 7% to 13%, 1 while it was 9% in another study of autopsies. 2 Fibroadenomas comprise about 50% of all breast biopsies, and this rate rises to 75% for biopsies in women under the age of 20 years. 3,4 Fibroadenomas are more frequent among women in higher socioeconomic classes 5-7 and in dark-skinned populations. 8 The age of menarche, the age of menopause, and hormonal therapy, including oral contraceptives, were shown not to alter the risk of these lesions. 6,7,9,10 Conversely, body mass index and the number of full-term pregnancies were found to have a negative correlation with the risk of fibroadenomas. [5][6][7]9,11 Moreover, consumption of large quantities of vitamin C and cigarette smoking were found to be associated with reduced risk of a fibroadenoma. 7,12,13 No genetics factors are known to alter the risk of fibroadenoma. However, a family history of breast cancer in firstdegree relatives was reported by some investigators to be related with increased risk of developing these tumors. 14,15 PATHOLOGYFibroadenomas usually form during menarche (15-25 years of age), a time at which lobular structures are added to the ductal system of the breast (Fig. 1). Hyperplastic lobules are common at that time, and may be regarded as a normal phase of breast development. 16 Hyperplastic lobules were shown to be histologically identical with fibroadenomas. 10,17 Analyses of the cellular components of fibroadenomas by means of polymerase chain reaction demonstrated that both the stromal and the epithelial cells are polyclonal, 18 supporting the theory that fibroadenomas are hyperplastic lesions associated with aberration of the normal maturation of the breast, ra...

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Section: Sonographymentioning

confidence: 99%

Management of breast fibroadenomas

1998

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“…By comparison, in series of adult women, approximately 15% to 55% of lesions fulfilled the classic sonographic criteria for fibroadenoma. [11][12][13] Three fibroadenomas in our study population were anechoic relative to glandular tissue and resembled simple cysts. This may be due to large amounts of epithelial tissue in these tumors.…”

Section: Discussionmentioning

confidence: 89%

“…8,9 In the adult population, fibroadenomas are also the most common palpable masses in women younger than 35 years. [10][11][12][13] On gross pathologic specimens, fibroadenomas are well-circumscribed lesions that usually have a round or oval shape. Histologically, they contain fibroepithelial elements with the fibrous stroma predominating.…”

Section: Discussionmentioning

confidence: 99%

“…Several authors have reported that the accuracy of sonography for the diagnosis of uncomplicated breast cysts in adults is nearly 100% if strict criteria are met. 4,13 These criteria include a round or an oval shape, sharp, well-circumscribed margins, an anechoic matrix, and posterior sound transmission. Cystic lesions in children are usually solitary and lined with simple columnar or cuboid epithelium.…”

Section: Discussionmentioning

confidence: 99%

“…For example, in fatty breasts, hypoechoic fibroadenomas may be mistaken for normal glandular tissue, particularly if lateral shadowing is absent. 13 Finally, very experienced operators performed the sonography; therefore, this setting may not be representative of all radiology practices.…”

Section: Discussionmentioning

confidence: 99%

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Gray scale sonography of breast masses in adolescent girls.

Kronemer

Rhee

Siegel

et al. 2001

J of Ultrasound Medicine

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Objective. To assess the sonographic findings of breast masses in adolescents and the usefulness of sonographic patterns for suggesting a specific diagnosis. Methods. The sonograms and medical records of 57 girls (mean age, 15.4 years) with palpable breast masses were retrospectively reviewed. Three observers reviewed the sonograms for multiple sonographic findings. Surgery or clinical findings established diagnoses. Statistical analysis was done to determine how well sonographic findings alone and in combination agreed with final histologic diagnoses. Results. Diagnoses included cysts (n = 12), abscesses (n = 7), fibroadenomas (n = 36), a lactating adenoma (n = 1), and a phyllodes tumor (n = 1). The sonographic findings varied significantly among lesion types (P ≤ .005). Conclusions. Our experience suggests that virtually all breast masses in a pediatric population are benign and that sonography has the ability to differentiate among cystic, inflammatory, and solid masses. Key words: sonography; breast; mass; adolescent. onography has become a widely used modality for characterizing breast masses in adults as cystic or solid, and it has been shown to be highly reliable for this purpose. [1][2][3][4][5] Although the specificity of various sonographic patterns has been reported in breast masses in adults, similar data are lacking in pediatric patients. Previous series have included small numbers of children 6 or were primarily performed with older technology. 7 In view of the advances in technology and the development of high-frequency transducers, a reevaluation of the role of sonography in the clinical evaluation of the pediatric breast is appropriate. We thus undertook this study to determine whether there are gray scale sonographic findings that are helpful in differentiating breast masses in adolescents.

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Sonographic and pathologic findings in typical and atypical medullary carcinomas of the breast

Cheung

Chen

Lee

et al. 2000

J. Clin. Ultrasound

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Purpose We investigated whether there was a relationship between the sonographic and histologic appearances of medullary carcinomas of the breast to determine whether sonography is helpful in the differentiation of typical and atypical medullary carcinomas. Methods We retrospectively reviewed the histologic slides and sonograms of 20 patients who had been diagnosed with medullary carcinoma of the breast. We then classified the carcinomas as typical or atypical based on strict histologic criteria. We also evaluated the relationship between sonographic findings and the histologic reclassification. Results Eight (40%) of the 20 medullary carcinomas were classified as typical, and 12 (60%) were classified as atypical. On sonography, a smooth outline was visualized in 6 (75%) of the 8 typical medullary carcinomas but in none of the 12 atypical carcinomas. A jagged margin was sonographically visualized in 10 (83%) of the 12 atypical carcinomas, and a focal irregularity in the margin was visualized in 2 (17%) of the 12 atypical carcinomas. Four of the typical medullary carcinomas had posterior enhancement, and 9 of the atypical medullary carcinomas showed retrotumoral shadowing. The difference in tumor‐margin regularity between typical and atypical medullary carcinomas was found to be statistically significant (p < 0.001) using the 2‐tailed Fisher's exact test. Conclusions To prevent overdiagnosis of medullary carcinoma, a thorough pathologic review of the entire tumor is recommended if sonography shows a jagged margin or a margin with focal irregularity. © 2000 John Wiley & Sons, Inc. J Clin Ultrasound 28:325–331, 2000.

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The Spectrum of Sonographic Findings of Fibroadenoma of the Breast

Cited by 68 publications

References 0 publications

Management of breast fibroadenomas

Management of breast fibroadenomas

Gray scale sonography of breast masses in adolescent girls.

Sonographic and pathologic findings in typical and atypical medullary carcinomas of the breast

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