title: Focal fibrosis of the breast: imaging characteristics and histopathologic correlation.
abstract: OBJECTIVE
  To characterize mammographic and ultrasonographic (US) features of focal fibrosis of the breast (FFB), to compare the radiologic and histopathologic findings, to investigate the incidence of FFB, and to determine if histopathologic diagnosis of FFB is an acceptable diagnosis for specific mammographic and US findings.
  
  
  METHODS
  Retrospective review of findings from 1,268 surgical excisional and 796 percutaneous breast biopsies (290 US-guided, 370 stereotactically guided, and 136 vacuum-assisted stereotactically-guided) revealed 44 (2.1%) diagnoses of FFB. Mammographic and US features were correlated with histopathologic types.
  
  
  RESULTS
  Thirty-seven (84%) of the 44 lesions diagnosed as FFB were visualized on mammograms and appeared as six (14%) circumscribed masses, two (5%) lobulated masses, one (2%) microlobulated mass, 11 (25%) obscured masses, two (5%) architectural distortions, and 15 (34%) asymmetric densities. Seven palpable lesions were not visualized on mammograms. Thirty-three of the 44 lesions were evaluated at US; 25 (76%) of 33 were visible. Twenty (80%) of 25 were well-defined hypoechoic masses; three (12%), ill-defined masses; and two (8%), marked shadowing without visible mass. At histopathologic examination, 17 (39%) of the 44 lesions were characterized as mass-like fibrosis; 14 (32%), as nodular fibrosis; 12 (27%), as haphazard fibrosis; and one (2%), as septal fibrosis. Histopathologic type and specific imaging findings did not correlate statistically.
  
  
  CONCLUSIONS
  FFB is a histopathologic entity that has a wide spectrum of imaging findings. It is an acceptable histopathologic result of percutaneous breast biopsy, provided that careful radiologic-histopathologic clinical correlation is performed.
authors.affiliation: Department of Radiology and Radiological Science, Breast Imaging and Interventional Center, Johns Hopkins Outpatient Center, 601 N Caroline St, Baltimore, MD 21287-0823, USA.
authors.forename: G
authors.initials: G
authors.lastname: Revelon
authors.forename: M E
authors.initials: ME
authors.lastname: Sherman
authors.forename: O M
authors.initials: OM
authors.lastname: Gatewood
authors.forename: R F
authors.initials: RF
authors.lastname: Brem
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D001940:Breast / Q000473:pathology; D001941:Breast Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D005348:Fibrocystic Breast Disease / Q000000981:diagnostic imaging; D005355:Fibrosis; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D012189:Retrospective Studies; D016217:Ultrasonography, Mammary