What is the role of imaging studies in the workup of phyllodes tumor (cystosarcoma phyllodes)?

Updated: Oct 10, 2018
  • Author: Donald R Lannin, MD; Chief Editor: John Geibel, MD, DSc, MSc, AGAF  more...
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Answer

Although mammography and ultrasonography generally are important in the diagnosis of breast lesions, they are notoriously unreliable in differentiating benign phyllodes tumors from malignant phyllodes tumors or from fibroadenomas. (The phyllodes tumor’s mammographic appearance, as a round density with smooth borders, is similar to that of fibroadenoma.) Thus, findings on imaging studies are not definitively diagnostic of phyllodes tumors. [17]

A retrospective study by Kawashima et al suggested that intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) could differentiate phyllodes tumors from fibroadenomas by comparing the apparent diffusion coefficient (ADC) values. [18]  The study included seven fibroadenomas and 15 phyllodes tumors (10 benign, four borderline, and one malignant). The authors found that on IVIM MRI, the ADC was higher in borderline and malignant phyllodes tumors than in fibroadenomas, whereas the opposite was true for the perfusion-related diffusion coefficient (D*).


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