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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.

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