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Ultrasound characteristics of sclerosing adenosis mimicking breast carcinoma

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Background

Sclerosing adenosis (SA) is a benign lesion with complicated pathological components and could mimic breast carcinoma in both clinical palpation and medical imaging findings. The present study was conducted to assess the value of ultrasound (US) characteristics in diagnosing SA and their differentiation from breast carcinoma.

Methods

We retrospectively reviewed the medical records of 305 women (347 lesions) with invasive ductal carcinoma (IDC) and 54 women with single SA lesion, who had breast excision between April 2016 and July 2018. US BI-RADS atlas and elastography were applied and their associated characteristics were compared between SA and IDC.

Results

The mean age of SA was younger than that of IDC (43.6 ± 7.4 vs 53.2 ± 10.3, P < 0.001). Compared to IDC, SA had more frequency of parallel orientation (94.44% vs 71.76%, P < 0.001) and circumscribed margin (48.15% vs 4.90%, P < 0.001), less frequency of irregular shape (64.81% vs 95.97%, P < 0.001), hypoechoic echotexture (88.89% vs 98.27%, P = 0.002), calcification (12.96% vs 55.04%, P < 0.001), and posterior acoustic changes (3.70% vs 53.89%, P < 0.001) or associated features (architectural distortion, 3.70% vs 59.65%, P < 0.001; duct changes, 18.52% vs 63.40%, P < 0.001). Vascularity absence was more common in SA compared to IDC (35.19% vs 6.63%, P < 0.001). And the elasticity score was lower in SA (2.38 ± 0.60 vs 3.91 ± 0.81, P < 0.001). After adjusting for age, we found spiculated margin, posterior shadowing, calcification, architectural distortion, and vascularity could independently identify the differences between these two entities. After involving elasticity score, the calcification and vascularity could still be independent indicators for differential diagnosis.

Conclusion

Understanding SA imaging features will enable radiologists to communicate results to the referring physician consistently, which could benefit a reliable assessment and specific management recommendations. A systematic evaluation of the US BI-RADS atlas together with breast elastography may be a powerful tool to identify SA and differentiate it from breast cancer.

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Funding

This study was funded by Harbin Science and Technology Bureau (CN) (Grant Number 2017RAQXJ178).

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Author notes

  1. Jiawei Tian contributed the same as the corresponding author Zhenzhen Wang.

Authors and Affiliations

  1. Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Rd, Harbin, 150086, Heilongjiang, China

    Wei Liu, Wei Li, Ziyao Li, Peng Zhao, Zihong Guo, Jiawei Tian & Zhenzhen Wang

  2. Radiation Oncology, Fourth Affiliated Hospital of Harbin Medical University, 37 Yiyuan St, Harbin, 150001, Heilongjiang, China

    Lei Shi

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  1. Wei Liu
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  2. Wei Li
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Correspondence to Zhenzhen Wang.

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Conflict of interest

The corresponding author Zhenzhen Wang has received a research grant from Harbin Science and Technology Bureau (CN). All the co-authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with animals performed by any of the authors. All procedures performed in studies involving human participants were in accordance with the ethical standards of our institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Liu, W., Li, W., Li, Z. et al. Ultrasound characteristics of sclerosing adenosis mimicking breast carcinoma. Breast Cancer Res Treat 181, 127–134 (2020). https://doi.org/10.1007/s10549-020-05609-2

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  • DOI: https://doi.org/10.1007/s10549-020-05609-2

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