Background: This study was performed to compare the mammographic, sonographic, and magnetic resonance imaging (MRI) characteristics of phyllodes tumors and fibroadenomas, which may resemble each other. Methods: Preoperative mammograms, B-mode and Doppler sonograms, and dynamic breast MRIs of 72 patients with pathologically proven fibroadenomas and 70 patients with pathologically proven phyllodes tumor were evaluated in this retrospective study. Statistical significance was evaluated using chi-square and Fisher's exact tests. Correlations in lesion size among radiological methods were examined by Pearson's correlation analysis. Results: The features that differed on mammogram were size, shape, and margin of the mass. Sonograms showed significant differences in size, shape, margin, echo pattern, and vascularization of the mass. Pearson's correlation analysis showed strong agreement among radiological methods in terms of assessment of size. Tumor size ≥ 3 cm, irregular shape, microlobulated margins, complex internal echo pattern, and hypervascularity were significant findings of phyllodes tumors. Internal cystic areas on MRI were frequently associated with phyllodes tumors. Conclusion: Mammographic, sonographic, and MRI findings of fibroadenomas and phyllodes tumors could help radiologists to ascertain imaging-histological concordance and guide clinicians in their decision making regarding adequate follow-up or the necessity of biopsy.

1.
Anderson BO, Lawton TJ, Lehman CD, Moe RE: Phyllodes tumors; in Harris JR, Lippman ME, Morrow M, Osborne CK (eds.): Diseases of the Breast, 3rd ed. Philadelphia, PA, Lippincott Williams & Wilkins, 2004, pp. 991-1006.
2.
Gatta G, Iaselli F, Parlato V, Di Grezia G, Grassi R, Rotondo A: Differential diagnosis between fibroadenoma, giant fibroadenoma and phyllodes tumour: sonographic features and core needle biopsy. Radiol Med 2011;116:905-918.
3.
Abe M, Miyata S , Nishimura S, Iijima K, Makita M, Akiyama F, Iwase T: Malignant transformation of breast fibroadenoma to malignant phyllodes tumor: long-term outcome of 36 malignant phyllodes tumors. Breast Cancer 2011;18:268-272.
4.
Reinfuss M, Mitus J, Duda K, Stelmach A, Rys J, Smolak K: The treatment and prognosis of patients with phyllodes tumor of the breast: an analysis of 170 cases. Cancer 1996;77:910-916.
5.
Wiratkapun C, Piyapan P, Lertsithichai P, Larbcharoensub N: Fibroadenoma versus phyllodes tumor: distinguishing factors in patients diagnosed with fibroepithelial lesions after a core needle biopsy. Diagn Interv Radiol 2014;20:27-33.
6.
Jacklin RK, Ridgway PF, Ziprin P, Healy V, Hadjiminas D, Darzi A: Optimising preoperative diagnosis in phyllodes tumour of the breast. J Clin Pathol 2006;59:454-459.
7.
Dillon MF, Quinn CM, McDermott EW, O'Doherty A, O'Higgins N, Hill AD: Needle core biopsy in the diagnosis of phyllodes neoplasm. Surgery 2006;140:779-784.
8.
Lee AH, Hodi Z, Ellis IO, Elston CW: Histological features useful in the distinction of phyllodes tumour and fibroadenoma on needle core biopsy of the breast. Histopathology 2007;51:336-344.
9.
Yılmaz E, Sal S, Lebe B: Differentiation of phyllodes tumors versus fibroadenomas. Mammographic and sonographic features. Acta Radiol 2002;43:34-39.
10.
Feder JM, de Paredes ES, Hogge JP, Wilken JJ: Unusual breast lesions: radiologic-pathologic correlation. Radiographics 1999;19:11-26.
11.
Yabuchi H, Soeda H, Matsuo Y, Okafuji T, Eguchi T, Sakai S, Kuroki S, Tokunaga E, Ohno S, Nishiyama K, Hatakenaka M, Honda H: Phyllodes tumor of the breast: correlation between MR findings and histologic grade. Radiology 2006;241:702-709.
12.
Bode MK, Rissanen T, Apaja-Sarkkinen M: Ultrasonography and core needle biopsy in the differential diagnosis of fibroadenoma and tumor phyllodes. Acta Radiol 2007;48:708-713.
13.
Foxcroft LM, Evans EB, Porter AJ: Difficulties in the preoperative diagnosis of phyllodes tumours of the breast: a study of 84 cases. Breast 2007;16:27-37.
14.
Buchberger W, Strasser K, Heim K, Müller E, Schröcksnadel H: Phyllodes tumor: findings on mammography, sonography and aspiration cytology in 10 cases. AJR Am J Roentgenol 1991;157:715-719.
15.
Jorge Blanco A, Vargas Serrano B, Rodríguez Romero R, Martínez Cendejas E: Phyllodes tumors of the breast. Eur Radiol 1999;9:356-360.
16.
Chao TC, Lo YF, Chen SC, Chen MF: Sonographic features of phyllodes tumors of the breast. Ultrasound Obstet Gynecol 2002;20:64-71.
17.
Stavros AT: Atypical, high-risk, premalignant, and locally aggressive lesions; in Stavros AT (ed.): Breast Ultrasound, 1st ed. Philadelphia, PA, Lippincott Williams & Wilkins, 2004, pp. 689-711.
18.
Chao TC, Lo YF, Chen SC, Chen MF: Phyllodes tumors of the breast. Eur Radiol 2003;13:88-93.
19.
Harper AP, Kelly-Fry E, Noe JS, Bies JR, Jackson VP: Ultrasound in the evaluation of solid breast masses. Radiology 1983;146:731-736.
20.
Hochmann MG, Orel SG, Powell CM, Schnall MD, Reynolds CA, White LN: Fibroadenoma: MR imaging appearances with radiologic-histopathologic correlation. Radiology 1997;204:123-129.
21.
Ogawa Y, Nishioka A, Tsuboi N, Yoshida D, Inomata T, Yoshida S, Moriki T, Toki T: Dynamic MR appearance of benign phyllodes tumor of the breast in a 20-year-old woman. Radiat Med 1997;15:247-250.
22.
Kinoshita T, Fukutomi T, Kubochi K: Magnetic resonance imaging of benign phyllodes tumors of the breast. Breast J 2004;10:232-236.
23.
Kuhl CK, Mielcareck P, Klaschik S, et al.: Dynamic breast MR imaging: are signal intensity time course data useful for differential diagnosis of enhancing lesion? Radiology 1999;211:101-110.
24.
Boetes C, Strijk SP, Holland R, Barentsz JO, Van der Sluis RF, Ruijs JHJ: False-negative MR imaging of malignant breast tumors. Eur Radiol 1997;7:1231-1234.
25.
Wurdinger S, Herzog AB, Fischer DR, Marx C, Raabe G, Schneider A, Kaiser WA: Differentiation of phyllodes breast tumors from fibroadenomas on MRI. AJR Am J Roentgenol 2005;185:1317-1321.
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