November 2014

Oval lobulated partly well defined and partly ill defined mass that is there for several years but not biopsied

Clinical Info

Has a slow-growing breast mass that is there since 2003. Patient was examined in 2003 but the lesion looked benign and was not biopsied. No images from 2003 are available. She returned in 2013.

Ultrasound Images & Clips

Oval lobulated mass that is there for several years but not biopsied

Oval mass that is for a part well defined and for a part not well defined
Oval mass that is for a part well defined and for a part not well defined
Detail image of the well defined part of the lesion
Detail image of the well defined part of the lesion
Transverse image of the well defined part
Transverse image of the well defined part
Detail of the not so well defined part
Detail of the not so well defined part
The lesion is several cm's large
The lesion is several cm's large
Mammography
Mammography
Mammography The lesion was biopsied and to our surprise proved to be a malignant phyllodes tumor. Phyllodes tumors tend to grow rapidly and this mass was rather slow growing
Mammography The lesion was biopsied and to our surprise proved to be a malignant phyllodes tumor. Phyllodes tumors tend to grow rapidly and this mass was rather slow growing
This is an image of another women 47 years old with a palpable breast lesion this image was taken in 2008
This is an image of another women 47 years old with a palpable breast lesion this image was taken in 2008
Transverse image from the mass in 2008 Biopsy showed a fibroadenona
Transverse image from the mass in 2008 Biopsy showed a fibroadenona
In march 2012 the lesion had grown rather fast
In march 2012 the lesion had grown rather fast
Another image of the mass
Another image of the mass
The mass is vascularized
The mass is vascularized
An elastogram showed a soft mass. Although the lesion has benign characteristics a repeat 14 G biopsy was performed and we asked the pathologist if the lesion could be a phyllodes tumor
An elastogram showed a soft mass. Although the lesion has benign characteristics a repeat 14 G biopsy was performed and we asked the pathologist if the lesion could be a phyllodes tumor
Again the result was fibroadenoma and half a year later the lesion had grown again
Again the result was fibroadenoma and half a year later the lesion had grown again
The lesion is still vascularized
The lesion is still vascularized
At the end of 2013 the lesion was so big that we had to use the extended field of view to get the mass in one image. The lesion was again biopsied for the third time and proved to be a phyllodes tumor The patholgist again looked at the older specimen and
At the end of 2013 the lesion was so big that we had to use the extended field of view to get the mass in one image. The lesion was again biopsied for the third time and proved to be a phyllodes tumor The patholgist again looked at the older specimen and
Mammography in 2008
Mammography in 2008
Mammography in 2012 In 2013 no new mammography was performed
Mammography in 2012 In 2013 no new mammography was performed

Conclusion

Although the lesion of the first patient was according to the patient there for 10 years the lesion proved to be a malignant phyllodes tumor. No metastases were found. The second patient had a very fast growing phyllodes tumor that at the time of operation had grown to 14 cm. At operation there proved to be a small localized area of DCIS grade 2. The rest of the lesion, however, was still benign. The pathologist told us that differentiation between a fibroadenoma and a benign phyllodes tumor can be very difficult no matter the size of the biopsy needle.


Details

  • Sex: Female
  • Age: 58

Created with

  • Hitachi Ultrasound System