MRI Differential Diagnosis Of Breast Adenosis And Breast Ductal Carcinoma With Pathological Correlation

Objective:To investigate the radiological features of breast adenosis and breast ductal carcinoma by dynamic contrast enhanced MRI(DCE-MRI),DWI and to correlate them to different pathological types.Methods:105 cases of breast adenosis and 78 cases of breast ductal carcinoma confirmed by surgical histopathology or biopsy were retrospectively analyzed in the study.All of the patients were examined preoperatively by DWI and DCE-MRI(Vibrant).MRI features of breast adenosis and breast ductal carcinoma with pathological correlation was analyzed.Clinical data,lesion location,size,pattern,nipple retraction,skin change,axillary adenopathy,the ADC values and enhancement pattern in the groups between different pathological types of breast adenosis and breast ductal carcinoma were evaluated and analyzed by using statistics test.Results:In 105 cases of breast adenosis,DCE MR images showed mass-like lesions(50 patients)and nonmass-like lesions(55 patients),In 78 cases of breast ductal carcinoma,DCE MR images showed mass-like lesions(52 patients)and nonmass-like lesions(26 patients).There were statistical significance between MLE lesions of breast adenosis and breast ductal carcinoma in subjective pain,palpation activity,morphological edge,enhancement pattern and TIC pattern(?2-12.718,5.743,4.478,6.158 and 13.127,respectively,all P<0.05).However,no differences were observed between 2 groups in size(?2=3.321,P>0.05).There were the nipple secondary retraction(6 patients)and skin thickening(16 patients)in MLE lesions of breast ductal carcinoma,but no cases were existed in MLE lesions of breast adenosis.The ADC values of MLE lesions of breast adenosis and ductal carcinoma were(131.63±21.8)×10-3mm2/s,(104.21±18.54)×10-3mm2/s,respectively.There were significant differences in the groups(F=52.167,P<0.01).Comparison of the same diagnostic performance between different pathological subtypes of PA,SA,DICS and IDC-NOS were respectively analyzed,MRI features with pathological correlation were analyzed.The suspicious features could be mis-leading in the lesions of SA.NMLE lesions of breast adenosis and breast ductal carcinoma enhancement patterns were diverse.There were statistical significance between NMLE lesions in subjective pain,palpation,pattern and TIC pattern(?2=15.136,10.827 and 15.136,respectively,all P<0.05).The ADC values of MLE lesions of breast adenosis and ductal carcinoma were(136.23±14.8)×10-3mm2/s,(102.51±16.44)×10-3mm2/s,respectively.There were significant differences between the groups(F=49.167,P<0.01).Conclusions:The characteristic of radiological findings could be found in breast adenosis using advanced MR imaging techniques,most of MLE lesions of breast adenosis were benignity-looking lesions,and NMLE lesions of breast adenosis in morphology were similar to malignant lesions,DCE-MRI combined with DWI are helpful in the differential diagnosis of breast ductal carcinoma.It showed these suspicious features could be mis-leading in the MRI interpretation in a group of patients with stromal fibrosis.There were no typical MRI features in SA.Breast MRI had certain advantages in preoperative diagnosis of SA,while the final diagnosis should only be based upon carefully histopathological examination of the lesion.