Authors: Ritsuko Yamada, Fumio Tsujimoto, Takanori Okamura, Motoki Miya-uchi, Masaru Sakurai.
Purpose: In this prospective study, patients with preoperative suspicious phyllodes tumor based on several diagnostic imaging analyses were carried out ultrasonic color Doppler assessments. then investigated whether the ultrasonographic evaluation is available in differentiate malignancy.
Subjects and Methods: Subjects studied were 72 patients diagnosed ultrasonographic phyllodes tumor. They were divided into 5 groups based on pathological diagnosis of the surgical specimen or biopsy: 15 patients with benign phyllodes tumor, borderline phyllodes tumor (12 patients), malignant phyllodes tumor (4), fibroadenoma (31), breast cancer (10). Postoperative review was carried out, comparing ultrasonographic features included maximum
flow velocity (Vmax), minimum flow velocity (Vmin), and resistance index (RI) levels between 5 groups.
Results: Onset ages in borderline and malignant phyllodes tumors were higher than those in fibroadenomas and breast cancers. Resistance Index (RI) levels in benign phyllodes tumors were, significantly lower than those in malignant phyllodes tumors and breast cancers. Maximal flow velocity levels in breast cancer were significantly higher than those in fibroadenoma, or benign phyllodes tumor (8.5+/-1.6cm/sec).
Discussion: It’s difficult to make the ultrasonographic diagnosis in phyllodes tumors which are 2 cm or less in diameter to distinguish from fibroadenomas. Careful observation in internal echo lead irregular shaped cystic component to the suspected diagnosis in phyllodes tumors. Giant tumors are not always malignant, however, tumors characterized with enlarged, vascular rich, or accelerated proliferation are suspected to be malignant.
Conclusion: In this study of ultrasonic Doppler findings in phyllodes tumors, it is suggested that RI and maximal velocity levels in benign ones are significantly low compared with those in breast cancers or malignant phyllodes tumors. It’s already known that RI levels greater than 0.8 are the evidence of malignant invasive cancers. It’s necessary to evaluate whether the high RI levels in a phyllodes tumor are applied as a clinical index of malignant one. It’s considered that furthermore studies in many cases are expected to clarify the diagnostic ultrasonic Doppler findings in phyllodes tumors whether those are malignant or not.
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