Stephanie Kay Patterson MD, Presenter: Nothing to Disclose

Deborah Oehler Jeffries MD, Abstract Co-Author: Nothing to Disclose

Annette Ingram Joe MD, Abstract Co-Author: Nothing to Disclose

Katherine Alison Klein MD, Abstract Co-Author: Nothing to Disclose

Colleen Neal MD, Abstract Co-Author: Nothing to Disclose

Chintana P. Paramagul MD, Abstract Co-Author: Nothing to Disclose

James Thomas Fitzgerald PhD, Abstract Co-Author: Nothing to Disclose

To assess the cancer incidence in solid palpable breast masses with probably benign imaging features and determine if biopsy may be avoided.

This study is IRB approved and HIPAA compliant. Our Radiology Information System was searched for all breast imaging reports in women 18 years and older, with solid, palpable masses with round, oval, lobular and circumscribed features described from 1/1/2000 – 12/31/2009. Mammography, ultrasound, clinical and pathology reports were reviewed. Age range was 18 – 87 yo with a median age of 33 yo. Women were grouped into age quartiles for analysis (ages 18-25, ages 26-33, ages 34-41, and ages 42 and older). A one-way analysis of variance (ANOVA) was used to examine cancer frequencies among these age groups (benign=0 and not benign=1).

837 masses in 727 patients were retrieved. 29 masses had been present for at least 3 years prior to the study period or had definite benign features and were not included in the analysis. 81 masses (9.7%) had no pathology and were lost to follow-up. 727 masses in 647 patients were analyzed. 608 masses had a pathologic diagnosis (608/727 – 84%). Cancer rate was 2.2% (16/727). Median cancer size = 20mm; median benign tumor size = 16mm. Median age of cancer patients = 45 yo; benign = 33 yo. 363 masses were prospectively thought to be fibroadenomas, including 7 cancers. Cancer histology included invasive ductal carcinoma NOS (5), malignant phyllodes (3), metaplastic (2), papillary (1), medullary (1), mucinous (2), and lymphoma (1). A focus of DCIS was noted in a mass with fibrocystic change. The most common benign tumor was a fibroadenoma (450/608 – 74%). The cancer frequency by age quartile was 1% for ages 18-25, 1% for ages 26-33, 2% for ages 34-41, and 6% for ages 42 and older. There were significant differences by age group (F ratio p ≤ .01). The frequency in the 42 and older group was significantly different from both the18-25 and the 26-33 age groups (Tukey's HSD global alpha = .05).

The overall cancer incidence in women with solid palpable breast masses with these features is low in this population, however, not less than 2 %. The frequency of cancer in younger women is low enough where short term follow-up may be considered in this age group.

Younger women with palpable, solid masses with probably benign features could be closely followed, rather than biopsied.

Patterson, S, Jeffries, D, Joe, A, Klein, K, Neal, C, Paramagul, C, Fitzgerald, J, Outcomes of Solid Palpable Masses: Breast Masses with Probably Benign Imaging Features — A Retrospective Analysis of 727 Masses.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11002635.html