Ultrasound Characteristics of Breast Fibroadenomas Are Related to Clinical and Histological Parameters

Zusammenfassung

Hypothese: Ultraschallcharakteristika von Fibroadenomen (FA) sind abhängig von klinischen und histologischen Parametern. Material und Methoden: Bei 221 FA wurden 11 gängige Ultraschallcharakteristika erfasst. Wir untersuchten den Einfluss des Patientinnenalters, der Tumorgröße und der histologischen Klassifizierung auf die Ausprägung dieser Charakteristika. Die FA waren vom adulten Typ und wurden unterteilt in floride, regressive und Mischtypen. Ergebnisse: Medianes Alter der 221 Patientinnen: 41 Jahre. Mittlerer größter Tumordurchmesser: 16 mm. Floride FA: bei jungen Frauen häufiger (p < 0,001) und größer als regressive FA (p = 0,007). Signifikante Unterschiede zwischen floriden und regressiven FA bezüglich: Schallfortleitung (p < 0,001), Echogenität (p = 0,003) und Wandkontur (p = 0,042). Bei größeren (> 16 mm) FA häufiger: horizontale Achse (p = 0,009), inhomogene Echogenität (p = 0,001), hyperechogene Spots (p < 0,001), verstärkte dorsale Schallfortleitung (p > 0,001), lobulierte Wandkontur (p = 0,009), starke Vaskularisation (p < 0,001). Bei größeren FA seltener: lateraler Schallschatten (p = 0,047). Bei den älteren Patientinnen (> 30 Jahre) häufiger: dorsale Schallabschwächung (p = 0,047), irreguläre Wandkontur (p = 0,038), homogene Echogenität (p = 0,047). Schlussfolgerung: Patientinnen-Alter, Tumorgröße und histologische Klassifizierung beeinflussen Ultraschallcharakteristika von FA. Dies kann bei der diagnostischen Klassifizierung und der Entscheidung für Biopsien hilfreich sein.

Abstract

Purpose: We hypothesized that ultrasound characteristics of breast fibroadenomas (FA) vary in relation to the clinical and histological parameters: patient age, tumor size and histological classification. Materials and Methods: Eleven ultrasound characteristics frequently observed in breast tumors were defined before the onset of our study. These characteristics, as well as a semi-quantitative score for vascularization on color-coded Doppler ultrasound, were analyzed in a retrospective study. Histology revealed adult type differentiation in all FA. They were divided into florid, regressive and mixed subtypes. The examiner was blinded for the histological classification during image analysis. Results: Histological type: florid FA: more frequent in younger women (age group < 30 years; p < 0.001), and bigger than regressive FA (larger than 16 mm: p = 0.007). Statistically significant differences between florid and regressive FA regarding the ultrasound features: enhanced posterior ultrasound transmission (p < 0.001), homogenous echo pattern (p = 0.003) and lobulated margin contour (p = 0.042). Tumor size: patients with larger tumors (> 16 mm) were younger (mean age 35 vs. 43 years, p < 0.001). More often in bigger FA: enhanced dorsal ultrasound transmission (p < 0.001), hyperechoic spots (p < 0.001), strong vascularization (p < 0.001), inhomogeneous echo pattern (p = 0.001), horizontal axis (p = 0.009), lobulated margin contour (p = 0.009), lateral shadowing (p = 0.047). Age: more often in older patients (age group > 30 years): dorsal ultrasound shadowing (p = 0.008), irregular margin contour (p = 0.038), homogenous echo pattern (p = 0.047). Conclusion: Histological type, tumor size and patient age significantly influence ultrasound characteristics of breast FA. This might be helpful to consider when breast lesions are classified and decisions for biopsies are made.

Key words

breast - ultrasound - tumor

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