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• Clinical Article •
Differentiation of phyllodes breast tumors from fibroadenomas using MRI
XUE Mei  LI Jing  ZHOU Chun-wu  LI Er-ni 

DOI:10.3969/j.issn.1674-8034.2014.04.002.


[Abstract] Objective: To evaluate the MRI appearance of phyllodes breast tumors and to differentiate them from fibroadenomas.Materials and Methods: MR images were obtained on GE medical system 3.0-T imager. MR images of 23 patients with 24 phyllodes breast tumors proved by surgery or biopsy pathology were retrospectively analyzed. The results were compared with the MRI appearance of 62 fibroadenomas of 59 patients by using Chi-square test Fisher's Exact test and t test.Results: There is statistical difference (P=0.004) in average maximum diameter between phyllodes breast tumor and fibroadenomas. Still, there is another statistical difference (P<0.05) in tumor shape and edge between the both. Phyllodes tumors show as lobulated shape commonly (12/24, 50.00%) or irregular shape sometimes (2/24, 8.33%), while fibroadenomas show as quasi-circular shape (29/62, 46.77%) or lobulated shape (27/62, 43.55%) commonly and no irregular shape seen. In the aspects of tumor edge, most fibroadenomas show smoothly (58/62, 93.55%) and less irregular edge. On the contrary, phyllodes tumors have more irregular edges (7 tumors with irregular edges (29.17%) and 1 tumor with spiculation). Meanwhile, 11 (11/24, 45.83%) phyllodes tumors show patchy hyperintense (bleeding tip) on T1WI compared with fibroadenomas, which has no this kind of signal. On T2WI fat saturation, it shows statistical difference (P=0.025) that phyllodes tumors have hyperintense mostly (21/24, 87.5%) with no isointense or hypointense and fibroadenomas have isointense, hypointense and mixed signal as well as hyperintense (43/62, 69.35%). Furthermore, cystic change area is to be seen in 8 (8/24, 33.33%) phyllodes tumors and no this kind of area in fibroadenomas. In terms of enhanced low signal lace and no-enhanced one, both tumors have not evidently statistical difference. Regarding of curve characteristic, the statistical difference (P=0.008) has showed that II type and III type is mostly seen in phyllodes tumors I type is seen at most in fibroadenomas. Finally, there is no evidently statistical difference (P=0.068) of average ADC between both tumors.Conclusions: There are differences between the phyllodes breast tumors and fibroadenomas on MRI performance. Several DCE-MR findings can be used to help differentiation of phyllodes breast tumors from fibroadenomas.
[Keywords] Breast neoplasms；Phyllodes tumor；Fibroadenoma；Magnetic resonance imaging；Diagnosis, differential

XUE Mei Department of Diagnostic Radiology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China

LI Jing* Department of Diagnostic Radiology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China

ZHOU Chun-wu Department of Diagnostic Radiology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China

LI Er-ni Department of Diagnostic Radiology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China

*Correspondence to: Li J, E-mail: dr.lijing@163.com

Conflicts of interest   None.

Received  2014-04-15
Accepted  2014-05-30
DOI: 10.3969/j.issn.1674-8034.2014.04.002
DOI:10.3969/j.issn.1674-8034.2014.04.002.

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