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Objective Differentiation of breast fibroadenoma from breast cancer is of great importance. The purpose of the ar-ticle was to evaluate the diagnostic efficacy of magnetic resonance imaging(MRI) in the differentiation of breast fibroadenoma from breast cancer in DCE-TIC ( dynamic contrast enchancement-time intensity curve) platform type ( typeⅡ) . Methods Between March 2014 and May 2016, 64 patients were included in our study, 19 patients with breast fibroadenoma and 45 patients with breast cancer. All the patients underwent DCE-MRI ( dynamic contrast-enhanced magnetic resonance imaging) examination before operation. Morpho-logic characteristics, hemodynamic characteristics, EER ( early enhancement rate) and ADC ( apparent diffusion coefficient) values were calculated and statistically compared. Results Among 19 cases of breast fibroadenoma, 9 cases were round or ovoid, 8 cases are lobulated, 2 cases were irregular, 15 cases with clear boundary, 14 cases in mammary gland vascular enlargement, 2 cases of slowinflows, 4 cases of moderate inflows, 13 cases of rapid inflows, and the average ADC value was ( 1. 47 ± 0. 38) × 10-3 mm2/s. Low signal separation present in 11 lesions of fibroadenoma. Among the 45 cases of breast cancer, 17 cases were round or ovoid, 7 cases were lobulat-ed, 21 cases were irregular, 11 cases with clear boundary, 38 cases of mammary gland vascular enlargement, 1 case of slow inflows, 5 ca-ses of moderate inflows, 39 cases of rapid inflows, and the averageADC values was (0.98±0.40)×10-3mm2/s. The shape, (χ2=9.176), margin (χ2=16.452), EER(χ2=18.489) and ADC between breast fibroadenoma and breast cancer were of significantly difference. No significant difference was found in the increased and enlarged blood vessels. The success of ADC values in differentation of breast fibroadenoma from breast cancer was statistically significant( P<0.001), and the area under the curve(AUC)of the ROC, sensitivity and specificity of VE were 94.7% and 71.1%. Conclusion Breast fibroadenoma are in fast inflows in the early phase on the DCE-MRI, and there are differences in morphologic characteristics and mass enhancement ways between patients with breast fibroadenoma and breast cancer. Morphologic characteristics combined with inter-nal low signal separation contribute to the differentiation of breast fibroadenoma from breast cancer.
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Objective To investigate the expression of thymidine kinase 1 (TK1) in benign and malignant tumors.Methods From Jan.2013 to May.2015,180 female patients with breast diseases aging 16 to 79 years,including 112 cases of breast cancer (breast cancer group),and 68 cases of breast fibroadenoma (breast fibroadenoma group) were collected.The mean age of the patients was 47 years,with a median age of 43 years.We collected all the patients' fasting venous blood,detected the level of TK1,compared their differences of expression levels between patients with fibroadenoma and breast cancer,and the differences in serum TK1 levels in patients with different pathological characteristics.Results The level of TK1 in breast cancer patients was significantly higher than that in patients with fibroadenoma,and the difference was statistically significant (P＜0.01).In breast cancer group,the tumor size was not correlated with TK1 expression of (P＞0.05).The level of serum TK1 in patients with advanced TNM stage was higher than that in patients with early TNM stage (P=0.038).The level of serum TK1 in patients with advanced lymph node stage was higher than that in early lymph node stage (P=0.048).The level of TK1 in M1 patients was higher than that in M0 patients and the difference had statistical significance (P=0.018).Conclusion TK1,as a new marker of cell proliferation index,can accurately reflect the proliferation of tumor cells in human body,which can be used as an important index to monitor the degree of tumor proliferation and identify benign and malignant tumors.
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Objective To investigate the MRI findings of the breast fibroadenoma which has a washout type of time signal intensity curve (TIC)for the purpose of improving imaging diagnosis.Methods The MRI findings of 20 cases of the breast fibroadenoma with a washout TIC and 20 cases of breast carcinoma verified by histopathology were analyzed retrospectively.Morphological features,internal signal, ADC value and dynamic enhancement performance of the two groups were compared with each other.Results The shapes of the breast fibroadenomas were more commonly ovoid or round (18/20),and the margins were circumscribed(16/20),Most of the fibroadenomas were high intensity in T2 WI with the non-contrast enhanced separations (9/20).The average minimum ADC value was (1.412±0.332)×10-3 mm2/s,and higher than that of breast cancer (0.888 ±0.1 60)×10 -3 mm2/s with the significant difference (P 0.05 ). Conclusion The breast fibroadenoma with washout TIC has a similar performance with the breast cancer in TIC and the early enhancement rate, however,the clear edge,higher T2 WI signal intensity,the non-contrast enhanced internal separations and higher ADC values are helpful to the diagnosis of breast fibroadenoma with washout TIC.
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Se describe el caso clínico de una paciente de 40 años de edad con carcinoma lobulillar in situ en el interior de un fibroadenoma de mama, quien fue atendida en la consulta externa especializada de mama del Hospital Oncológico Provincial Docente "Conrado Benítez García" de Santiago de Cuba, donde se le realizaron exámenes ecográfico y mamográfico que mostraron un nódulo benigno, por lo cual se decidió efectuar nodulectomía. La fémina evolucionó satisfactoriamente y en la actualidad se mantiene con seguimiento trimestral.
The case report of a 40 year patient with in situ lobulillar carcinoma within a breast fibroadenoma who was assisted in the breast specialized outpatient department of "Conrado Benítez García" Teaching Provincial Oncological Hospital in Santiago de Cuba is described, where echographical and breast exams were carried out which showed a benign nodule, reason why it was decided to carry out a nodulectomy. The patient had a satisfactory clinical course and at present she is under quarterly follow-ups.
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Fibroadenoma , Breast Carcinoma In Situ , Secondary Care , Breast DiseasesABSTRACT
Objective To explore the surgery methods for multiple fibroadenoma of breast,provide a ref erence for the surgical treatment of breast multiple fibroadenoma.Methods The clinical data of 152 cases of breast multiple fibmadenoma admitted from January 2008 to October 2012 in Department of Breast Surgery,Obstetrics and Gynecology Hospital of Fudan University were analyzed retrospectively.All the cases were applied intraoperative B-ultrasound guided,taken the areola incision through breast subcutaneous layer approach for resection of multiple breast fibroadenoma.The surgical incision design,surgical procedures and results of operations were analyzed.Results All 152 cases fibroadenoma were resected which were guided by B-ultrasound with areola incision.One month and three months after operation,the assessment of physician-patient for the scars were different.There was no significance in the Pearson Correlations which were 0.894 (P =0.106) and 0.905 (P =0.065),respectively.But twelve months later,it satisfied with the appearance of scar,either the patients or the doctors (P ＜ 0.05).The Pearson Correlation was 0.946 (P ＜0.001).Conclusions B-ultrasound guided areola incision through the breast subcutaneous layer approach could removal multiple breast fibroadenoma at one time,patients were satisfacted with the good cosmetic results,we believe this operation method has short operation time and good clinical value.
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Objective To study the ultrasonographic and acoustic contrast features of breast fibroadenoma and breast cancer and explore the value of contrast enhanced ultrasonography in the differential diagnosis of benign and malignant breast tumors. Method A retrospective analysis of 18 cases breast fibroadenoma and 12 cases breast cancer in the performance of contrast-enhanced ultrasound was done. Results After contrast agent injection, tumor dimension increased in 4 cases with breast fibroadenoma and 7 cases with breast cancer. The ultrasonographic and acoustic contrast features of breast fibroadenoma showed no significant changes. They showed stenosis, perpendicular and circumambulates vascular shape. The breast cancers significantly increased the number of tumor blood vessels with the thicker,tortuous blood vessels into the tumor. Conclusions The contrast enhanced ultrasonography assessed more accurate size of tumors. The image displayed grown sizes, more vascularity and bending vascular shape in the breast cancer. It was more accurate than gray-scale ultrasound on diagnosing breast cancer.
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Objective To investigate the value of ultrasound-guided Mammotome minimal invasive system in the treatment of breast fibroadenoma.MethodsFrom January 2007 to October 2008,266 benign breast lesions of 183 cases were treated by ultrasound-guided Mammotome minimal invasive system.The diameter of the masses ranged from 4 to 25 mm(≤ 10 mm in 73 cases,10-20 mm in 148,and ≥ 20 mm in 45).ResultsThe 266 lesions in the 183 patients were excised completely by using the Mammotome system.The excision was performed for a mean of 15 times in each case(ranged from 5 to 44 times) with an average operation time of 26 minutes(10 to 60 minutes).No complication was found after the surgery except slight subcutaneous ecchymosis in 2 cases.The length of the incisional scar,which was not apparent,ranged from 2.5 to 4 mm.The 183 cases were followed up by ultrasonography for 2 to 22 months(mean,12 months),during which their BI-RADS scales ranged from Ⅰ to Ⅱ,no local recurrence was found.ConclusionsUltrasound-guided Mammotome minimally invasive system is feasible for total resection of breast fibroadenoma with appropriate sizes.The technique leads to fewer complications and good cosmetic results.Further studies on the system are necessary for the treatment of multiple breast fibroadenomas.
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Ojective To evaluate the clinical application of ultrasound-guided Mammotome system to the treatment of patients with breast fibroadenoma. Methods The minimally invasive operations for 53 breast fibroadenoma in 43 patients were performed by ultrasound-guided Mammotome system, and the therapeutic efficacy of Mammotome system was evaluated. Results 53 lesions (0.6cm～2.2cm) in 43 patients with breast fibroadenoma were completely excised by the Mammotome system. The average incisions were 17 times and the mean operative time was 31 min. All the operations were successfully accomplished without serious complication. The length of incision was only 3 mm. And no recurrence was found by physical examination and B-ultrasonography in 15 patients(21 lesions) during follow up period for 6～21(13.5?4.0) months. Conclusions Mammotome system is simple and effective technique with minimal invasion for the excision of small breast fibroadenoma.