Ultrasound Lexicon in diagnosis and management of breast fibroadenoma: when to follow up and when to biopsy

Engy A Ali ,Soha Talaat

doi:10.1186/s43055-019-0125-5

Engy A Ali , Soha Talaat

Open Access

https://doi.org/10.1186/s43055-019-0125-5

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Abstract

BackgroundTo detect the accuracy of breast ultrasound in diagnosis of fibroadenoma and differentiate between typical and atypical ones. The impact of ultrasound criteria on patient management. (Biopsy versus follow up). A prospective study were done to 71 patients. Diagnosis was reached either by performing follow up study or after revision of core biopsy/surgical specimens.ResultsIn our study, we had 35 ultrasound detected atypical fibroadenoma, seven out of the 35 (20 %) proven to be complex fibroadenoma by pathology while in another 20 patients, 36 fibroadenomas with typical criteria were detected by both ultrasound and regular follow up. The most ultrasound features which showed statistical significance were the posterior shadowing feature (100% atypical versus 25% typical with significant p value < 0.01), and vessel arrangement (85.7% versus 0% have central arrangement with significant p value < 0.01) helped to differentiate between simple and complex ones. We calculate the sensitivity, specificity, PPV, and NPV to be 100%, 74%, 46%, and 100%.ConclusionArrangement of vessels and posterior features are the most important criteria to differentiate simple and complex FAD.

Highlights

To detect the accuracy of breast ultrasound in diagnosis of fibroadenoma and differentiate between typical and atypical ones
Group I Twenty patients had 36 fibroadenomas with typical benign criteria on ultrasound; six of them underwent excisional biopsy and proved to be typical, the other 14 patients were followed up for 3, 6, and 12 months either prospective or retrospective according to time of presentation and showed stationary course
Patients were categorized into two groups according to ultrasound criteria: Group II Thirty two patients had 35 atypical fibroadenomas age range (19–41) years and their mean age 28.8 with atypical ultrasound criteria

Summary

Introduction

To detect the accuracy of breast ultrasound in diagnosis of fibroadenoma and differentiate between typical and atypical ones. Diagnosis was reached either by performing follow up study or after revision of core biopsy/surgical specimens. Fibroadenomas (FAD) are mostly benign tumors consisted of both epithelial and stroma contents. They are usually noticed in young-aged women [1]. Those who are obese or gained weight (20–3 kg) within 18 years showed high risk of appearance of fibroadenoma. Fibroadenomata have an inverse relationship with increasing age [2]. It is the most seen benign tumor in the breast in young women. Fibroadenomata may undergo infarction during pregnancy as it outgrew its blood supply presenting with painful mass in women [3]

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