Ultrasonographic findings of phyllodes tumor of breast with different pathological types

Abstract

Objective To study the diagnostic value and method of color Doppler ultrasonography in different pathological types of breast phyllodes tumor. Methods The characteristics of ultrasonographic images were analyzed retrospectively in 49 female patients with breast phyllodes tumor in Jiangyin Hospital of Traditional Chinese Medicine and the Affiliated Jiangyin Hospital of Southeast University Medical College from January 2008 to September 2018, ranged from 17-74 (45.78±10.50) years old. The pathological percentages of benign, borderline and malignant were 40.81% (20/49), 42.86% (21/49) and 16.33% (8/49), respectively. The maximum diameter line of the lesion, ultrasound breast imaging reporting and data system(BI-RADS) assessment category and the level of blood supply according to color Doppler ultrasonography were compared among benign, borderline and malignant pathological types. The ultrasonographic finding of two tumors of different diameter sizes(≥5 mm vs. <5 mm) were compared. Results The mean maximum diameter line of the lesions among three pathological types were (3.57±2.17) cm, (5.00±3.71) cm, (2.88±1.52)cm, respectively, and there was no significant difference (F=2.083, P>0.05). In all the 49 patients, 6 patients were ultrasound BI-RADS categorised 0, 24 patients were categorised 3, 12 patients were categorised 4 and 7 patients were categorised 5. The ultrasound BI-RADS assessment category, among benign, borderline and malignant of breast phyllodes tumor, had statistically significant difference (H=22.732, P<0.05). According to the color Doppler ultrasonography, the rich blood supply rate of benign, borderline and malignant lobar tumors were 35.00%(7/20), 52.45%(11/21)and 8/8, respectively, with significant difference (χ2=12.786, P<0.01). Grayscale sonography showed the incidence of internal liquefaction of maximum diameter ≥5 cm was 6/10, higher than that of <5 cm (17.9%, 7/39)(χ2=5.224, P<0.05). Conclusions The possibility of phyllodes tumor should be considered when breast tumor is lobulated and cystic on ultrasound. The ultrasound BI-RADS assessment category maybe helpful to distinguish benign, borderline and malignant of breast phyllodes tumor. The possibility of malignancy should be considered when the breast lesion present with rich blood supply. However, the diagnosis still depends on pathology. Key words: Breast neoplasms; Phyllodes tumor; Ultrasonography; Diagnosis