The study included 350 patients with different types of adenosis involving one or both breasts.
Mammographic findings varied with the type of breast adenosis and included focal architectural distortion,
focal densities or diffuse lesions,
round,
oval or spiculated masses with both well-circumscribed and poorly defined margins as well as clustered microcalcifications.
Ultrasonographic findings also varied,
ranging from irregular,
oval or lobulated masses with well-circumscribed margins to focal acoustic shadowing without mass configuration.
On contrast-enhanced breast MRI most lesions appeared either as enhancing masses or as non-mass enhancements.
All types of enhancing curves have been recorded on kinetic curve assessment (persistent,
plateau and wash-out type of delayed enhancement).
Representative MRI findings are displayed in Figures 1 - 7.
Fig. 1: Breast MRI findings in a 50-year old woman with bilateral breast adenosis. The images show a non-mass lesion in the left breast demonstrating a persistent (type 1) kinetic curve, suggestive of benign etiology.
Fig. 2: Breast MRI findings in a 50-year old woman with bilateral breast adenosis. The images reveal two adenosis lesions in the right breast with persistent (type 1) kinetic curves.
Fig. 3: Breast MRI findings in a 46-year old woman with breast adenosis. The images reveal two adenosis lesions in the left breast. The lesions appear less prominent and the contrast enhancement decreased in intensity compared to a previous MRI scan performed 3 months earlier, suggesting a benign etiology. The absence of diffusion restriction on DWI sequences (Figure 4) is also suggestive of benignity.
Fig. 4: DWI sequences of the patient with breast adenosis from Figure 3. The absence of diffusion restriction of contrast enhancing lesions shown in Figure 3 is rather suggestive of a benign etiology.
Fig. 5: Post-contrast images in a 57-year old woman with bilateral breast adenosis and left breast cancer. The image displays the kinetic curves of 4 adenosis lesions in the right breast.
Fig. 6: Breast MRI findings in a 57-year old woman with bilateral breast adenosis and left breast cancer. A lobulated lesion in the left breast demonstrates prominent contrast enhancement with a wash-out (type 3) kinetic curve and diffusion restriction on DWI sequences (Figure 7), consistent with malignancy. The kinetic curves of the right breast lesions are displayed in Figure 5.
Fig. 7: DWI sequences of a 57-year old woman with bilateral breast adenosis and left breast cancer (other images are displayed in Figures 5 and 6). A lobulated lesion in the left breast (pointed by arrows) associated with prominent contrast enhancement with a wash-out kinetic curve on post-contrast images (Figure 6) is also demonstrating diffusion restriction on DWI sequences, consistent with malignancy.