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The study of the imaging features and pathological of breast sclerosing adenosis
LI Yan-cui  LIANG Wen  PENG Feng-he  WANG Hai-li  WANG Xiao-yan  PENG Ru-chen 

DOI:10.12015/issn.1674-8034.2018.02.011.


[Abstract] Objective: To analyze the imaging features of breast sclerosing adenosis (SA) in mammography, ultrasound and MRI, and to explore their diagnostic values in preoperative examination.Materials and Methods: Imaging findings in 41 women (43 cases) with SA lesions confirmed by pathology were retrospectively reviewed (including 39 cases of mammography, 38 cases of ultrasound and 29 cases of MRI), imaging features of the disease were observed, and staged according to the breast imaging reporting and data system (BI-RADS). Malignancy were defined as BI-RADS≥4B, and misdiagnosis rates were calculated.Results: In the 43 SA lesions, 29 were simple SA lesions, and additional apocrine metaplasia, fibroadenoma, intraductal papilloma and focal calcifications were observed in 5, 4, 4 and 1 lesions, retrospectively. (1) Mammography findings: 39 women included irregular nodules (23.1%), asymmetric density (20.5%), structural distortions (20.5%), calcified masses (20.5%) and simple calcifications (7.7%), and no abnormal finding was observed in three cases. (2) 38 patients were examined by ultrasound, 35 were nodules, and 3 had no abnormalities. Most of the lesions were hypoechoic (92.1%), no or a small number of linear blood flow signals (92.1%), the echo was uneven (71.1%), and the boundary was clear (76.3%). (3) 29 patients with SA undergoing MRI, 65.5% were inhomogeneous long T2WI signal; All lesions showed marked enhancement, including 37.9% lesions showed irregular patchy or regional enhancement, 62.1% lesions with mass-like enhancement enhanced (7 star-shaped masses included). For the time intensity curve (TIC), 11 cases were type Ⅰ , 16 cases type Ⅱ, and 2 cases type Ⅲ, DWI lesions showed slightly higher signal in 16 casea. The misdiagnosis rates of mammography, ultrasound and MRI were 19.4% (10/39), 17.1% (6/35) and 17.2% (5/29), respectively. Combined these three methods, the accuracy were 93.1%.Conclusions: The majority of SA lesions showed nodules or calcification in mammography, ultrasound showed uneven hypoechoic nodules with less or no blood flow, the MRI showed inhomogeneous long T2WI signal, star-shaped mass-like lesions on enhanced. Morphology, time intensity curve and DWI image of lesions may show great value in identification of benign and malignant lesions. Combined these three methods, the diagnostic accuracy of SA can be improved.
[Keywords] Breast diseases；Breast sclerosing adenosis；Mammography；Ultrasound；Magnetic resonance imaging；Pathology

LI Yan-cui Department of Radiology, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China

LIANG Wen Department of Ultrasonography, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China

PENG Feng-he Department of Radiology, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China

WANG Hai-li Department of Radiology, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China

WANG Xiao-yan Department of Radiology, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China

PENG Ru-chen* Department of Radiology, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China

*Corresponding to: Peng RC, E-mail: 13501271260@163.com

Conflicts of interest   None.

Received  2017-11-18
Accepted  2018-01-05
DOI: 10.12015/issn.1674-8034.2018.02.011
DOI:10.12015/issn.1674-8034.2018.02.011.

[1]
Visscher DW, Nassar A, Degnim AC, et al. Sclerosing adenosis and risk of breast cancer. Breast Cancer Res Treat, 2014, 144(1): 205-212.
[2]
Gunhan-Bilgen I, Memis A, Ustun EE, et al. Sclerosing adenosis: Mammographic and ultrasonographic findings with clinical and histopathological correlation. Eur J Radiol, 2002, 44(3): 232-238.
[3]
Wang JC, Yang Y, Miao CM, et al. The analysis of clinical X-ray manifestations for breast sclerosing adenosis. J Med Imaging, 2016,17(6): 515-516.王金昌，杨越，缪春梅，等．乳腺硬化性腺病临床X线征象分析．实用医学影像杂志, 2016, 17(6): 515-516.
[4]
Cho SH, Park SH. Mimickers of breast malignancy on breast sonography. J Ultrasound Med, 2013, 32(11): 2029-2036.
[5]
Zheng L, Lü XM, Hang FG. Ultrasonographic of sclerosing adenosis and diagnostic values of ultrasonography. Chin J Ultrasonogr, 2016, 25(3): 263-264.郑磊，吕夕明，黄福光．乳腺硬化性腺病的超声诊断价值．中华超声影像学杂志, 2016, 25(3): 263-264.
[6]
Min P, Peng H, Jiang GB. Meta-analysis of the value of diffusion-weighted imaging differential diagnosis for be-nign and malignant breast tumors. Modern Oncology, 2015, 23(22): 3316-3319.闵朋，彭虹，江广斌．磁共振扩散加权成像鉴别诊断良恶性乳腺肿瘤价值的Meta分析．现代肿瘤医学, 2015, 23(22): 3316-3319.
[7]
Yang Y, Xu W, Rong DD, et al. General non-enhancedment MRI combined with DWI in screening of breast cancer initial trial at 3.0 T. J Pract Radiol, 2012, 28(12): 1895-1901.杨英，许卫，戎冬冬，等. 3.0 T MRI普通平扫联合DWI对乳腺癌筛查的初步探讨．实用放射学, 2012, 28(12): 1895-1901.
[8]
Zhang XM, Lin J, Ye F, et al. Value of diffusion-weighted imaging with different b values in the diagnosis of breast lesions at 3.0 T MRI. Chin Comput Med Imag, 2012, 18(3): 219-223.张雪梅，林江，叶芳，等．乳腺良恶性病变的3.0 T磁共振扩散加权成像鉴别诊断及b值优化．中国医学计算机成像杂志, 2012, 18(3): 219-223.
[9]
Oztekin PS, Tuncbilek I, Kosar P, et al. Nodular sclerosing adenosis mimicking malignancy in the breast: magnetic resonance imaging findings. Breast J, 2011, 17(1): 95-97.
[10]
Yao GY, Yao WQ, Zhang L. Xray diagnosis and clinically pathological analysis with sclerosing adenosis of the breast. J Pract Radiol, 2014, 30(10): 1650-1652.姚国燕，姚文青，张璘．乳腺硬化性腺病的X线诊断及临床病理分析．实用放射学, 2014, 30(10): 1650-1652.
[11]
Chen WJ, Wang QS, Zeng B, et al. Comparative study of dynamic MRI, mammography, and ultrasonic in the diagnosis of breast lesions. Chin J Magn Reson Imaging, 2012, 3(2): 125-128.陈文静，汪青山，曾斌，等．乳腺病变动态增强MRI、乳腺摄影片、超声、病理对照研究．磁共振成像, 2012, 3(2):125-128.
[12]
Gity M, Arabkheradmand A, Taheri E, et al. Magnetic resonance imaging features of adenosis in the breast. J Breast Cancer, 2015, 18(2): 187-194.

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