Phyllodes Tumour of the Breast: Differentiation of Histological Grade by Ultrasonography

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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

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





GW Shin、YM Park、JH Park、HJ Kim、HJ Choo、HJ Baek、DW Kim、SJ Lee、JH Ryu


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%)。