Phyllodes Tumour of the Breast: Differentiation of Histological Grade by Ultrasonography
GW Shin, YM Park, JH Park, HJ Kim, HJ Choo, HJ Baek, DW Kim, SJ Lee, JH Ryu
Hong Kong J Radiol 2019;22:107-13
https://doi.org/10.12809/hkjr1916906
Objectives: To retrospectively evaluate whether benign and aggressive phyllodes tumours have distinguishing ultrasonographic features.
Methods: We searched the breast imaging database for patients with diagnoses of phyllodes tumours between 2003 and 2014. The imaging studies of eligible patients were retrospectively reviewed.
Results: A total of 46 patients (all women; mean age, 41.1 years; range, 20-69 years) were enrolled in the study. The histological grades were benign in 67.4% (n = 31), borderline in 23.9% (n = 11), and malignant in 8.7% (n = 4) of patients. The mean long-axis diameter of the tumour was 3.1 cm (range, 0.7-6.9 cm) in benign tumours and 5.8 cm (range, 3.0-13.0 cm) in aggressive tumours. As compared with benign phyllodes tumours, aggressive tumours showed larger long-axis diameter (p = 0.01), more frequently irregular shape (60% vs. 3.2%), indistinct or microlobulated margins (66.7% vs. 25.8%), and complex cystic and solid echogenicity (46.7% vs. 0%). Benign phyllodes tumours more commonly showed heterogeneous echogenicity with small anechoic clefts (54.8% vs. 20.0%).
Conclusion: Several sonographic findings including long-axis diameter, shape, margin, and echogenicity were helpful to differentiate benign and aggressive phyllodes tumours. Irregular shape was a strong, independent predictor of aggressive phyllodes tumours.
Author affiliation(s):
GW Shin, YM Park, JH Park, HJ Choo, DW Kim, SJ Lee: Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
HJ Kim: Department of Radiology, Kyungpook National University Medical Center, Republic of Korea
HJ Baek: Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Republic of Korea
JH Ryu: Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Republic of Korea
中文摘要
乳腺葉狀腫瘤：超聲波檢查對組織學分級的影響
GW Shin、YM Park、JH Park、HJ Kim、HJ Choo、HJ Baek、DW Kim、SJ Lee、JH Ryu
目的：回顧性評估良性和侵襲性乳腺葉狀腫瘤是否有可以區分兩者的超聲波特徵。
方法：我們從乳腺成像數據庫中檢索在2003年至2014年期間診斷葉狀腫瘤患者，對符合條件患者的影像學檢查進行回顧分析。
結果：共46名患者被納入研究（全部為女性；平均41.1歲，年齡介乎20至69歲）。組織學分級為良性佔67.4%（n = 31）、臨界佔23.9%（n = 11）、惡性佔8.7%（n = 4）。良性葉狀腫瘤的平均長軸直徑為3.1 cm，侵襲性葉狀腫瘤則為5.8 cm。與良性腫瘤相比，侵襲性腫瘤有較大長軸直徑（p = 0.01）；並較為常見不規則形狀（60%比3.2%）、不清楚或微小分頁狀邊緣（66.7%比25.8%）和複雜的囊性和實質性迴聲（46.7%比0%）。良性腫瘤較常見微小的不均勻迴聲中伴無回聲裂（54.8%比20.0%）。
結論：超聲波檢查中的長軸直徑、形狀、邊緣和迴聲有助區分良性和侵襲性葉狀腫瘤。不規則形狀是侵襲性葉狀腫瘤的强獨立預測因子。