Fibrocystic Changes of the Breast: Radiologic–Pathologic Correlation of MRI

Breast MRI provides high sensitivity but modest positive predictive value for identifying breast cancers, with approximately 75% of MRI-guided biopsies returning benign pathologies. Fibrocystic change (FCC) is a descriptive term used colloquially by many radiologists (and falling out of favor with many pathologists) to refer to several benign entities encountered in the breast. Many of the benign entities believed to comprise FCC can show enhancement on MRI. Recognizing the pathologic correlates of these enhancing lesions should help guide management after such a result on MRI-guided biopsy. Premenopausal women may present with clinical symptoms attributed to FCC, including pain, nipple discharge, breast lumps, or discrete masses. Benign entities associated with FCC include proliferative lesions such as usual ductal hyperplasia and sclerosing adenosis, and nonproliferative lesions including cysts, apocrine metaplasia, and stromal fibrosis. Fibrocystic change can be diffuse or focal. Diffuse FCC usually presents as non-mass enhancement (NME), often with persistent kinetics. Focal FCC can present as an irregular mass or focus with variable enhancement patterns including washout kinetics. Following a benign concordant MRI-guided biopsy result of one or more of the above entities, follow-up with MRI in 12 months is reasonable. Accurate radiologic–pathologic correlation can be achieved when careful review of histologic findings is carried out in the context of MRI features.

Clinicopathological study of benign breast diseases a study of 50 cases

Background: Benign breast diseases are a neglected entity in developing countries despite the fact that they involved in the majority of breast complaints. Benign breast disorders can be defined as any non-malignant breast condition and involved wide range of clinical and pathological disorders. Breast diseases present as swellings. It is a symptom/sign for a different lesion varying from developmental abnormality, inflammatory lesions, epithelial and stromal proliferation to malignancy. Patients were studied on the basis of i.e., clinically, and histopathological ultrasound has done. Our purpose of study is to document various benign Brest diseases to study different mode of presentations of diseases and correlation of clinical and pathological diagnosisMethods: The given study was a prospective and observational study, undertaken in the department of general surgery, govt. medical college Surat, during the study period of March 2018 to September 2019.All the female and male patients with breast related disease were included in this study. Female patients with biopsy proven malignancy were excluded from the study.Results: The study comprised of 50 patients with benign breast diseases; the most common is Fibro adenoma which formed 68% then fibrocystic diseases 20%. With most common age group involved in our study is 21-30 years.Conclusions: Benign breast diseases are more common but ignored entity though it carries majority of complaints and occur mainly in young women less than 30 years of age and were mostly fibro adenoma and fibrocystic change.

Prevalence of Breast Complaints in Women with Mastopathy in Khorramabad

Background: Evaluation and screening of breast cancer demand significant primary care practice. Breast pain and nipple discharge are the frequent complaints owing to the benign conditions. Objective: In this study, we have investigated the prevalence of breast complaints among women referred to our clinic in Khorramabad, Iran. Methods: This is a cross-sectional study about the prevalence of breast-related complaints in women with breast problems referred to surgery clinic over a period 6 months. Results: Among 151 patients, following outcomes were seen; breast pain (60.3%), lump (27.8%), nipple discharge (4%), lump with pain (4.6%) and other (0.7%). 11 patients were presented lump malignancy (23.9%) including; fibrocystic change (56.5%) and fibro-adenoma (19.6%). Conclusion: This study showed that breast pain was the most common of all complaints and fibrocystic change was the most detected lump-type. Lumps were frequent in single women whereas, mastalgia in common in married women.

Pure Fibrocystic Change Diagnosed at MRI-guided Vacuum-assisted Breast Biopsy: Imaging Features and Follow-up Outcomes

Objective Fibrocystic change (FCC) is considered one of the most common benign findings in the breast and may be commonly seen on breast MRI. We performed this study to identify MRI characteristics of pure FCC on MRI-guided vacuum-assisted breast biopsy (VABB) without other associated pathologies and describe the findings on MRI follow-up and outcomes. Methods A retrospective review was performed for 598 lesions undergoing 9-gauge MRI-guided VABB at our institution from January 2015 to April 2018, identifying 49 pure FCC lesions in 43 patients. The associations between variables and lesion changes on follow-up MRI were analyzed using exact Mann-Whitney tests and Fisher’s exact tests. Results MRI features of pure FCC are predominantly clumped nonmass enhancement (19/49, 39%) or irregular masses with initial fast/late washout kinetics (9/49, 18%). There was no upgrade to high-risk or cancerous lesions among the 11 patients (25.6%) who underwent surgery. There were 22 pure FCC lesions in 19 (44.2%) patients who had follow-up MRI (mean 18.0 months, range 11–41 months) showing regression (13, 59%), stability (8, 36%), or progression (1, 5%) of the lesion size, and no cancers were found on follow-up at the site of the MRI biopsy for fibrocystic changes. No patient demographics or lesion features were associated with lesion regression or stability (P > 0.05). Conclusion Our study shows that MRI features of VABB-proven FCC lesions may mimic malignancy. After VABB of pure FCC, given that adequate sampling has been performed, a 12-month follow-up MRI may be reasonable.