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Contrast-enhanced ultrasonography image of a hamartoma in the left breast of a 35-year-old female. (a) Heterogeneous lesion on conventional ultrasound; (b) Contrast-enhanced ultrasonography image showed the enhancement pattern of hamartoma which was higher than that of the peripheral parenchyma, and the edge of the lesion was very clear b
Source publication
Aims: To present the ultrasound (US), shear-wave elastography (SWE), and contrast-enhanced ultrasonography (CEUS) features of breast hamartomas.
Subjects and Methods: In this retrospective analysis, we included 36 breast hamartomas of 36 female patients who had been scheduled for US-guided vacuum-assisted biopsy (VAB) or surgical excision between M...
Context in source publication
Citations
... However, it is largely limited by the scope of conventional morphological diagnosis, insufficient observation indicators, strong subjectivity in diagnosis, and susceptibility to factors such as machine performance and operator manipulation; thus, relying solely on conventional ultrasound to diagnose and grade tumors may not be sufficient (5). In recent years, rapid contrastenhanced ultrasound (CEUS) and shear wave elastography (SWE) have been applied to the clinical diagnosis of breast lesions (6). CEUS can dynamically observe the blood supply in the tumor, qualitatively and quantitatively evaluate the blood flow changes in the tumor, and discern between benign and malignant breast lesions (7). ...
Background
The value of contrast-enhanced ultrasound (CEUS), shear wave elastography (SWE) and their combination in the diagnosis of benign and malignant breast lesions have not been systematically evaluated. This study aimed to evaluate the diagnostic value of CEUS combined with SWE in benign and malignant breast lesions.
Methods
We searched six electronic databases for literature to evaluate the value of CEUS combined with SWE in the diagnosis of benign and malignant breast lesions from inception to May 2023. Review Manager 5.4 (Cochrane), Meta-DiSc 1.4, and Stata 14.0 (StataCorp) were used for meta-analysis. The pooled sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and the area under the curve (AUC) were calculated to evaluate the diagnostic performance.
Results
Ultimately, 17 studies were analyzed including 1,962 lesions in total. The overall quality of the included literature was acceptable, and no significant publication bias was found among the included studies. The pooled diagnostic performance measures for CEUS were as follows: SEN: 0.86 [95% confidence interval (CI): 0.84–0.88], SPE: 0.78 (95% CI: 0.75–0.80), PLR: 4.10 (95% CI: 2.86–5.90), NLR: 0.20 (95% CI: 0.15–0.25), DOR: 23.68 (95% CI: 16.77–33.44), and AUC: 0.90 (95% CI: 0.87–0.93); while, for SWE, SEN: 0.83 (95% CI: 0.81–0.86), SPE: 0.81 (95% CI: 0.78–0.83), PLR: 4.36 (95% CI: 3.18–5.97), NLR: 0.22 (95% CI: 0.17–0.29), DOR: 23.13 (95% CI: 14.70–36.40), and AUC: 0.90 (95% CI: 0.87–0.92). The measures for the pooled diagnostic performance of CEUS combined with SWE were as follows: SEN: 0.92 (95% CI: 0.90–0.94), SPE: 0.87 (95% CI: 0.85–0.89), PLR: 7.10 (95% CI: 5.24–9.61), NLR: 0.11 (95% CI: 0.07–0.16), DOR: 83.51 (95% CI: 49.67–140.39), and AUC: 0.96 (95% CI: 0.94–0.98). There was no statistically significant difference in SEN, SPE, and accuracy (ACC) between CEUS and SWE (P>0.05), but they were significantly lower than those of CEUS combined with SWE (P<0.001).
Conclusions
The diagnostic performance of CEUS combined with SWE is higher than that of using CEUS or SWE alone and can further improve the diagnosis of breast lesions.
... In our series, 14 patients were biopsied and nine (64%) patients were diagnosed preoperatively with hamartoma, whereas five (36%) patients were diagnosed with non-hamartoma. Previous studies reported that breast hamartomas cannot be followed up without surgery in patients with small-sized hamartomas with histopathological diagnosis (23,24). ...
Abstract
Objective: Breast hamartomas are rare, benign, and slow-growing breast tumors that can be definitively diagnosed by combining the results of clinical, radiological, and histopathological examination. This study aimed to evaluate the clinical, radiological, and histopathological features of hamartomas and summarize our clinical approach to hamartomas.
Materials and methods: Patients diagnosed with breast hamartoma between 2010 and 2020 in our clinic were retrospectively analyzed. Demographic information, clinical examination, radiological findings, histopathological features, changes during follow-up, and follow-up data were obtained and analyzed.
Results: Of the 1,429 patients operated on in our clinic for benign breast diseases between January 2010 and March 2020, 39 (2.7%) were diagnosed with breast hamartomas with histopathological examination. All patients were women with a median age of 37 (19-62) years. Most of the patients (64%) were in the premenopausal period. Radiological examinations were conducted using mammography (66%), breast ultrasonography (100%), and breast magnetic resonance imaging (48%). Biopsy was performed in 14 preoperative patients, and nine (64%) patients were diagnosed with hamartoma. All patients were operated on; 37 patients underwent a lumpectomy, and two had a mastectomy. No patients had hamartoma recurrence during an average follow-up period of 39 months.
Conclusion: Hamartomas are similar to other benign breast pathologies. Definitive diagnosis can be achieved by combining the results of clinical, radiological, and histopathological examination. Given its similar composition to normal breast tissue, hamartoma has a low rate of malignancy. Definitive diagnosis and appropriate surgical treatment are required.
Keywords: Breast; diagnostic imaging; hamartoma; surgery.
... Multiple sections were scanned continuously, and the target lymph nodes were locked in several lymph nodes detected, and one or more clear and meaningful ones in the sonogram were taken for examination [12][13][14]. The largest long axis section of the lymph node was taken, the probe was kept stable and switched to the contrast mode [15][16][17][18]. The 2 ml contrast agent was quickly injected into the elbow vein, followed by injection of 5 ml normal saline, and the section remained unchanged, and the timer was started. ...
Objective:
To explore the correlation between rim enhancement features of contrast-enhanced ultrasound and lymphatic metastasis, and to provide theoretical support for clinical treatment of breast cancer.
Methods:
387 breast cancer patients (748 axillary lymph nodes in total) treated in our hospital from January 2017 to January 2020 were selected and analyzed by contrast-enhanced ultrasound. Pathological examination showed that 540 axillary lymph nodes showed metastasis whereas 208 axillary lymph nodes did not show metastasis. Univariate analysis and Logistic stepwise regression were used to analyze the correlation between rim enhancement features of contrast-enhanced ultrasound and axillary lymph node metastasis of breast cancer.
Results:
Peripheral halo, peripheral convergence, rim enhancement, enhancement mode, enhancement amplitude, enhancement sequence, expansion after enhancement, peak intensity, time to peak, area under curve, thrombolysis in myocardial infarction, perfusion sequence, aspect ratio, and maximum cortical thickness were all related to lymph node metastasis of breast cancer by univariate analysis, and the difference was statistically significant (P < 0.05). Multivariate analysis showed that enhancement mode, enhancement amplitude, extension after enhancement, maximum cortical thickness, peak intensity and time to peak were all related to lymph node metastasis of breast cancer.
Conclusion:
Rim enhancement features of contrast-enhanced ultrasound of breast cancer are related to lymph node metastasis, which will provide a guidance for clinical treatment of breast cancer.
... Actually US imaging has made progress in recent years. The appearance of shear wave elastography and contrast-enhanced ultrasonography provided more accurate diagnosis for hamartoma (11). Doctors could diagnose mammary hamartoma based on some typical characteristics in US, which made US-guided vacuum-assisted breast biopsy (VABB) become an alternative for those who refused regular check and surgical operation. ...
... With the development of US technique and increasing experience on these diseases, radiologists could diagnose mammary hamartoma depend on some special characteristics in US images. Hyperechoic pseudocapsule, heterogeneous internal echogenicity, multiple stratification or target sign were typical signs of hamartomas in breast US images (11). Actually mammary hamartomas were found mostly in US examination in our institution. ...
Background:
Mammary hamartomas were mostly benign tumors with rare rate of recurrence and malignant transformation. Ultrasound (US)-guided vacuum-assisted breast biopsy (VABB) has been reported sufficiently safe in treating many breast benign tumors but remained undefined in mammary hamartoma for its usual underdiagnosis in US. Thus, this study aims to evaluate the efficiency of US-guided VABB in treating mammary hamartomas.
Methods:
From May 2015 to March 2019, 3,388 lesions of 2,534 patients underwent percutaneous US-guided VABB, among which 31 mammary hamartomas proved by pathology were included in this study. Patients were followed up by US three, six and twelve months later, then at 1-year intervals. Lesions were classified to analyze the possible factors associated with excision rate, bleeding volume and complications.
Results:
Of the 31 patients, recurrence was seen in 1 case in 1 year after the procedure and complete excision rate was 96.8% (30/31). The bleeding volume ranged from 1 to 15 mL (mean number ± standard deviation, 6.5±3.4 mL) and significant statistical differences were detected in patient age and the largest diameter of lesions. The main complications included pain (22.6%), hematomas (9.7%) and ecchymosis (3.2%).
Conclusions:
US-guided VABB ensures an outstanding complete excision rate and provides an alternative solution to treat mammary hamartomas.
Breast hamartomas are uncommon slowly growing lesions. Imaging findings are specific and usually relay on common mammographic picture of breast within breast appearance. I present a case of 48 years female patient, with recent history of palpable right breast mass, the imaging findings are atypical for breast hamartoma. The unusual presentation of breast hamartomas necessitates biopsy to exclude tumor. Incidence of malignancy is low, however has been reported before. Characteristic radiological imaging can help to minimize unnecessary surgery and morbidity.
