Long Axis to Short Axis Ratio of Breast Masses Pre-Diagnosed as Fibroadenomas on Ultrasonography. Can it Be a Useful Tool in Predicting Malignancy?
Abstract
Objectives: The purpose of this study was to calculate the long-axis-to-short axis ratio of breast masses pre-diagnosed as fibroadenoma (FA) on ultrasonography and determine its role in predicting malignancy.
Materials and Methods: Between January 2011 and March 2014, 1,154 patients who underwent tru-cut biopsy for the evaluation of solid breast masses encountered on imaging were evaluated. Of these, patients with breast masses that were diagnosed as FA based on ultrasonographic findings were included (n=707) into the study. The long axis ratio of lesions with only 1-2 lobulations or had well circumscribed borders, homogenous echogenicity was measured parallel to the skin. The patient’s clinical characteristics and demographic data, imaging and pathology findings were reviewed.
Results: Pathology findings revealed malignancy in 13 (1.8%) patients. Two of these were <40 years and 11 of them were >40 years (p=0.003). The long axis-short axis ratio was 1.8 for the benign cases and 1.4 for the malignant cases. The cut off value of the two ratios was calculated to be 1.4 (p=0.001). Most of the lesions were on right side and upper outer quadrant (n=394, 55.7% and n=389, 55% respectively). The rate of malignancy was similar according to location.
Conclusion: Breast masses diagnosed as FA based on imaging with a long axis to short axis ratio less than 1.4 may be at an increased risk for malignancy despite the presence of benign sonographic features. In patients older than 40 with notable risk factors, a detailed review of pathological findings is strongly encouraged.
Keywords
Fibroadenoma, Benign Breast Mass, Breast Imaging
Ethical Statement
Ethics Committee Approval: Bakırkoy Dr. Sadi Konuk Training and Research Hospital Ethical Committee for Clinical
Research (Nr: 2014/09/26).
Informed Consent: A written consent was obtained from all patients.
Peer-review: Externally peer-reviewed. Authorship Contributions
Surgical and Medical Practices: A.S., M.G.Ü., E.Ö., H.F.B.,
Concept: A.S., M.F.Ç., A.C.D., H.A.,
Design: M.G.Ü., A.S., M.F.Ç.,S.K.,
Data Collection or Processing: A.S., H.F.B., E.Ö.,
Analysis or Interpretation: S.K., H.A., A.C.D.,
Literature Search: A.C.D., H.F.B.,
Writing: A.S., M.G.Ü.
Conflict of Interest: No conflict of interest was declared by
the authors.
Financial Disclosure: The authors declared that this study
received no financial support.
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