The Value Of Differential Diagnosis Between Small Breast Phyllodes Tumor And Small Breast Fibroadenoma By Ultrasonography

OBJECTIVE:Phyllodes tumor is a rare breast disease. Phyllodes tumor and other benign and malignant tumors of breast compared, there are many similarities in sonogram. Large phyllodes tumor of breast should be differentiated from breast cancer and giant fibroadenoma. Small size are difficult to identify with fibroadenoma. Objective to explore the value of differential diagnosis of small breast phyllode tumor and small breast fibroadenoma by ultrasonography. For early detection of breast phyllodes tumor.METHODS:1. Clinical data:Twelve patients with breast phyllodes tumors were submitted to color Doppler ultrasonography from October 2008 to October 2009, mass number twelve, range 1.3-4.7centimeter in diameter, an average of 3.6 centimeter. Eighty-two patients with fibroadenomas were admitted over the same period, mass number ninety-six, range 1.0-4.9 centimeter in diameter,an average of 3.2 centimeter. All tumors were confirmed by pathology.2. Equipment and method:The equipment in the study was Philips HDI5000, probe frequency is 7～12MHZ. All tumors were examined by ultrasonography, using color Doppler flow imaging showed blood flow and record the velocity parameters. Armpit routine scanning in order to detect whether the lymph nodes.3. Statistical method:The two sets of sample rates were compared byχ2 test. T test was used to compare the number of the two sets of samples, and all bySPSS13.0.RESULTS:1. Comparison of two-dimensional sonography:Comparison of shapes, borders, whether or cystic, with or without calcification and the echos behind tumors of the two masses. The detection rates of cystic in breast phyllodes tumor group and fibroadenoma group were 33.3% and 1%. Comparing the rate of two samples statistically significant difference was found. Five calcifications were found in fibroadenoma group; phyllodes tumor group was no calcification.2. Comparison of color Doppler flow imaging:According to Adler semi-quantitative method, blood flows were divided into 0,Ⅰ,ⅡandⅢgrade level. All cases of phyllodes tumor group were found in blood flow (12/12). The detection rate of blood flow in fibroadenoma group was 61.5% (59/96), in which there are 48 cases of gradeⅠblood flow, accounting for 81.4% of the total (48/59). The detection rates of gradeⅡblood flow in breast phyllodes tumor group and fibroadenoma group were 41.7% and 10.4%. The detection rates of gradeⅢblood flow in the two groups were 25% and 1%. The detection rates of gradeⅠblood flow in the two groups were 33.3% and 50%. Compared the sample rates of the two groups, the detection rate of gradeⅡand gradeⅢblood flow in the two groups was statistically significant difference.3. Comparison of velocity parameters:The average peak systolic velocity of breast phyllodes tumor group and fibroadenoma group were (12.50± 5.22) cm/s and (11.96±6.58)cm/s; The average resistance index in the two groups were 0.69±0.08 and 0.66±0.05. No statistically significant difference between the two sets of parameters.4. Comparison of diagnostic value:Cystic degenerations and gradeⅢblood flows in a higher specificity and accuracy of the diagnosis. Specificity were 99%; Accuracy were 91.7% and 90.7%.CONCLUSIONS: Cystic degenerations and gradeⅢblood flows have a higher value in the differential diagnosis of small size (diameter＜5cm) phyllodes tumors and fibrosdenomas. GradeⅡblood flows can provide a reference for the differential diagnosis.