Differentiation of phyllodes breast tumors from fibroadenomas on MRI.
OBJECTIVE
The purpose of our study was to evaluate the MRI appearance of phyllodes breast tumors and to differentiate them from fibroadenomas.


METHODS
MR images were obtained on a 1.5-T imager. T1- and T2-weighted sequences and dynamic 2D fast-field echo T1-weighted sequences were performed. MR images of 23 patients with 24 phyllodes breast tumors (one malignant, 23 benign) were analyzed with respect to morphology and contrast enhancement. The tumors were compared with the MRI appearance of 81 fibroadenomas of 75 patients.


RESULTS
Well-defined margins were seen in 87.5% of the phyllodes tumors and 70.4% of the fibroadenomas, and a round or lobulated shape in 100% and 90.1%, respectively. A heterogeneous internal structure was observed in 70.8% of phyllodes tumors and in 49.4% of fibroadenomas. Nonenhancing internal septations were found in 45.8% of phyllodes tumors and 27.2% of fibroadenomas. A significantly greater increase in signal was seen on T2-weighted images in the tissue surrounding phyllodes tumors (21%) compared with fibroadenomas (1.2%). Most of both lesions appeared with low signal intensity on T1- and T2-weighted images. After the administration of contrast material, 33.3% of phyllodes tumors and 22.2% of fibroadenomas showed a suspicious signal intensity-time course.


CONCLUSIONS
Phyllodes breast tumors and other fibroadenomas cannot be precisely differentiated on breast MRI. Phyllodes tumors have benign morphologic features and contrast enhancement characteristics suggestive of malignancy in 33% of cases.
Wurdinger
Susanne
S
Department of Mammography, Institute of Diagnostic and Interventional Radiology, Friedrich Schiller University, Bachstrasse 18, Jena D-07740, Germany. Susanne.Wurdinger@med.uni-jena.de
Herzog
Aimée B
AB
Fischer
Dorothee R
DR
Marx
Christiane
C
Raabe
Gerd
G
Schneider
Achim
A
Kaiser
Werner A
WA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis*; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D018226:Fibroadenoma / Q000175:diagnosis*; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D003557:Phyllodes Tumor / Q000175:diagnosis*
D003287:Contrast Media; D019786:Gadolinium DTPA