Fibroadenoma breast

1. SONOMAMMOGRAM 18 yr old female with mobile swelling in the Rt breast Retroareolar region for last 8 months . Non tender, Minimal change in the consistency with menstrual cycle . MERCURY IMAGING INSTITUTE SCO 172-173 SEC 9C CHANDIGARH MERCURY IMAGING CENTRE SCO 16-17 SEC 20D CHANDIGARH

2. This case........................... Well defined encapsulated iso / hyperechoic mass lesion in the Retroareolar / central part of the Rt breast . The lesion has whorled appearance with evident posterior acoustic enhancement and no edge shadowing. Tiny specks of calcification are appreciated in the lesion. No probe tenderness over the lesion. Maintained nonchaotic vascularity in the substance and the periphery of the lesion. No perilesional stranding / satellite nodules appreciated. The lesion rests on the pectoralis bed with maintained interface and fat planes. Mobility present on compression .

3. Fibroadenoma breast TDLU – Terminal ductal lobular unit Estrogen induced tumor orifginating from the TDLU. Marginal increase in size at the end of the cycles. Regresses after menopause. Recurrence appreciated with estrogen therapy.

4. WHORLED APPEARANCE POSTERIOR ACOUSTIC ENHANCEMENT ENCAPSULATED MASS

5. RESTING ON PECTORALIS MAJOR WITH MAINTAINED INTERFACE AND FAT PLANES

6. WHORLED APPEARANCE WITH INTRASUBSTANCE HETEROGENOUS HYPERECHOIC/ HYPOECHIC AREAS.

7. COLOR DOPPLER ASSESMENT

8. NON CHAOTIC INTEGERATED INTRASUBSTANCE VASCULARITY

9. DEFINED CAPSULE APPRECIATED

10. APPRECIATE POSTERIOR ACOUSTIC ENHACEMENT

11. FIBROADENOMA BREAST SIGNS WITH FIBROADENOMA Halo sign – Pseudocapsule . Hump and Dip sign – Small bulge often continues with the adjacent small sulcus . Length / Depth ratio >1.4 Clinical size = Radiographic size. Varied calcification patterns ( popcorn like is pathognomic ) CHARACTERISTIC Third most common lesion of the breast. Most common breast tumor of the under 25 year age group. Usually oval. Usually hypoechoic Usually homogenous Usually regular ( may be lobulated ). Macrocalcifications ( 10%). Posterior acoustic enhancement ( 17% to 25%). MR appreciates the septations better.