title: Differentiation between phyllodes tumor and fibroadenoma using real-time elastography.
abstract: OBJECTIVE
  Phyllodes tumors (PT) are a rare entity accounting for less than 1 % of all breast lesions. They have a malignancy rate of 25-30%. Differentiation from benign fibroadenomas is difficult using ultrasound, mammogram and MRI. The elastic characteristics of both tumors were examined using real-time elastography (RTE) to find specific patterns that make differentiation possible.
  
  
  METHODS
  From February 2007 to May 2009, a total of 620 women were examined by RTE. Histological diagnosis was achieved using core needle biopsy. 123 of the lesions were fibroadenomas, 8 were phyllodes tumors. All patients underwent mammography and ultrasound followed by RTE. Sonography was performed by Acuson Antares, Premium Edition® (Siemens, Erlangen, Germany) with a 7 and 10 MHz transducer.
  
  
  RESULTS
  All phyllodes tumors had a similar elastic pattern with an elastic center and inelastic outer limits, referred to as the "ring sign". It was found in 5% of all fibroadenomas.
  
  
  CONCLUSIONS
  RTE provides a specific elastic pattern, which is sufficient for differentiating between a fibroadenoma and a phyllodes tumor. Therefore, the detection of the most suspicious lesion in women with the coexistence of multiple fibroadenomas and phyllodes tumors seems easier.
authors.affiliation: Diagnostische Radiologie, Universität Erlangen, Erlangen, Germany. boris.adamietz@uk-erlangen.de
authors.forename: B R
authors.initials: BR
authors.lastname: Adamietz
authors.forename: L
authors.initials: L
authors.lastname: Kahmann
authors.forename: P A
authors.initials: PA
authors.lastname: Fasching
authors.forename: R
authors.initials: R
authors.lastname: Schulz-Wendtland
authors.forename: M
authors.initials: M
authors.lastname: Uder
authors.forename: M W
authors.initials: MW
authors.lastname: Beckmann
authors.forename: M
authors.initials: M
authors.lastname: Meier-Meitinger
mesh_terms: D000328:Adult; D001707:Biopsy, Needle; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques; D005260:Female; D018226:Fibroadenoma / Q000000981:diagnostic imaging* / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D003557:Phyllodes Tumor / Q000000981:diagnostic imaging* / Q000473:pathology; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary