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Breast
Histopathologic Diagnoses
Benign Lesions
Fibrosis
Fibrosis
Nicole S. Winkler, MD; Wei Tse Yang, MBBS
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Focal fibrosis, stromal fibrosis, fibrous mastopathy
                • Fibrosis associated with fibrocystic change
                • Fibrous tumor; breast sclerosis

              • Definitions

                • Benign entity with wide spectrum of imaging findings
                • Excess of fibrous tissue compared to other portions of breast; may be global in extent
                • Historically described as palpable mass reflecting densely collagenized stroma
                • Now mostly incidental abnormal finding on screening mammography, US or MR
                  • Causes ↑ mammographic density, focal or diffuse

              IMAGING

              • General Features

                • Mammographic Findings

                  • Ultrasonographic Findings

                    • MR Findings

                      • Nuclear Medicine Findings

                        • Imaging Recommendations

                          • Image-Guided Biopsy

                            DIFFERENTIAL DIAGNOSIS

                              PATHOLOGY

                              • General Features

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              • Image Interpretation Pearls

                                                Selected References

                                                1. Suvannarerg V et al: Clinical, mammographic, and ultrasonographic characteristics of diabetic mastopathy: A case series. Clin Imaging. 53:204-9, 2018
                                                2. Yilmaz R et al: Stromal fibrosis: imaging features with diagnostic contribution of diffusion-weighted MRI. Br J Radiol. 91(1085):20170706, 2018
                                                3. Dratwa C et al: Breast MR biopsy: pathological and radiological correlation. Eur Radiol. 26(8):2510-9, 2016
                                                4. Kim J et al: Diabetic mastopathy: imaging features and the role of image-guided biopsy in its diagnosis. Ultrasonography. 35(2):140-7, 2016
                                                5. Moschetta M et al: Diabetic mastopathy: a diagnostic challenge in breast sonography. J Clin Ultrasound. 43(2):113-7, 2015
                                                6. Malik N et al: Underestimation of malignancy in biopsy-proven cases of stromal fibrosis. Br J Radiol. 87(1039):20140182, 2014
                                                7. Shin S et al: Stromal fibrosis of the breast: outcome analysis. Acta Radiol. 55(4):409-15, 2014
                                                8. Chan CL et al: Diabetic mastopathy. Breast J. 19(5):533-8, 2013
                                                9. Bowman E et al: Pseudoangiomatous stromal hyperplasia (PASH) of the breast: a series of 24 patients. Breast J. 18(3):242-7, 2012
                                                10. Lee SJ et al: MRI features of stromal fibrosis of the breast with histopathologic correlation. AJR Am J Roentgenol. 197(3):755-62, 2011
                                                11. Taskin F et al: Fibrotic lesions of the breast: radiological findings and core-neddle biopsy results. Eur J Radiol. 80(3):e231-6, 2011
                                                12. Chen JH et al: Fibrocystic change of the breast presenting as a focal lesion mimicking breast cancer in MR imaging. J Magn Reson Imaging. 28(6):1499-505, 2008
                                                13. Goel NB et al: Fibrous lesions of the breast: imaging-pathologic correlation. Radiographics. 25(6):1547-59, 2005
                                                14. You JK et al: Focal fibrosis of the breast diagnosed by a sonographically guided core biopsy of nonpalpable lesions: imaging findings and clinical relevance. J Ultrasound Med. 24(10):1377-84, 2005
                                                15. Shetty MK et al: Sonographic findings in focal fibrocystic changes of the breast. Ultrasound Q. 18(1):35-40, 2002
                                                16. Sklair-Levy M et al: Stromal fibrosis of the breast. AJR Am J Roentgenol. 177(3):573-7, 2001
                                                17. Revelon G et al: Focal fibrosis of the breast: imaging characteristics and histopathologic correlation. Radiology. 216(1):255-9, 2000
                                                18. Harvey SC et al: Fibrous nodules found at large-core needle biopsy of the breast: imaging features. Radiology. 211(2):535-40, 1999
                                                19. Rosen EL et al: Focal fibrosis: a common breast lesion diagnosed at imaging-guided core biopsy. AJR Am J Roentgenol. 173(6):1657-62, 1999
                                                20. Venta LA et al: Imaging features of focal breast fibrosis: mammographic-pathologic correlation of noncalcified breast lesions. AJR Am J Roentgenol. 173(2):309-16, 1999
                                                21. Berg WA et al: Predictive value of specimen radiography for core needle biopsy of noncalcified breast masses. AJR Am J Roentgenol. 171(6):1671-8, 1998
                                                22. Berg WA et al: Lessons from mammographic-histopathologic correlation of large-core needle breast biopsy. Radiographics. 16(5):1111-30, 1996
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Pathology

                                                        • Clinical Issues

                                                          • Diagnostic Checklist

                                                            TERMINOLOGY

                                                            • Synonyms

                                                              • Focal fibrosis, stromal fibrosis, fibrous mastopathy
                                                              • Fibrosis associated with fibrocystic change
                                                              • Fibrous tumor; breast sclerosis

                                                            • Definitions

                                                              • Benign entity with wide spectrum of imaging findings
                                                              • Excess of fibrous tissue compared to other portions of breast; may be global in extent
                                                              • Historically described as palpable mass reflecting densely collagenized stroma
                                                              • Now mostly incidental abnormal finding on screening mammography, US or MR
                                                                • Causes ↑ mammographic density, focal or diffuse

                                                            IMAGING

                                                            • General Features

                                                              • Mammographic Findings

                                                                • Ultrasonographic Findings

                                                                  • MR Findings

                                                                    • Nuclear Medicine Findings

                                                                      • Imaging Recommendations

                                                                        • Image-Guided Biopsy

                                                                          DIFFERENTIAL DIAGNOSIS

                                                                            PATHOLOGY

                                                                            • General Features

                                                                              • Gross Pathologic & Surgical Features

                                                                                • Microscopic Features

                                                                                  CLINICAL ISSUES

                                                                                  • Presentation

                                                                                    • Demographics

                                                                                      • Natural History & Prognosis

                                                                                        • Treatment

                                                                                          DIAGNOSTIC CHECKLIST

                                                                                          • Consider

                                                                                            • Image Interpretation Pearls

                                                                                              Selected References

                                                                                              1. Suvannarerg V et al: Clinical, mammographic, and ultrasonographic characteristics of diabetic mastopathy: A case series. Clin Imaging. 53:204-9, 2018
                                                                                              2. Yilmaz R et al: Stromal fibrosis: imaging features with diagnostic contribution of diffusion-weighted MRI. Br J Radiol. 91(1085):20170706, 2018
                                                                                              3. Dratwa C et al: Breast MR biopsy: pathological and radiological correlation. Eur Radiol. 26(8):2510-9, 2016
                                                                                              4. Kim J et al: Diabetic mastopathy: imaging features and the role of image-guided biopsy in its diagnosis. Ultrasonography. 35(2):140-7, 2016
                                                                                              5. Moschetta M et al: Diabetic mastopathy: a diagnostic challenge in breast sonography. J Clin Ultrasound. 43(2):113-7, 2015
                                                                                              6. Malik N et al: Underestimation of malignancy in biopsy-proven cases of stromal fibrosis. Br J Radiol. 87(1039):20140182, 2014
                                                                                              7. Shin S et al: Stromal fibrosis of the breast: outcome analysis. Acta Radiol. 55(4):409-15, 2014
                                                                                              8. Chan CL et al: Diabetic mastopathy. Breast J. 19(5):533-8, 2013
                                                                                              9. Bowman E et al: Pseudoangiomatous stromal hyperplasia (PASH) of the breast: a series of 24 patients. Breast J. 18(3):242-7, 2012
                                                                                              10. Lee SJ et al: MRI features of stromal fibrosis of the breast with histopathologic correlation. AJR Am J Roentgenol. 197(3):755-62, 2011
                                                                                              11. Taskin F et al: Fibrotic lesions of the breast: radiological findings and core-neddle biopsy results. Eur J Radiol. 80(3):e231-6, 2011
                                                                                              12. Chen JH et al: Fibrocystic change of the breast presenting as a focal lesion mimicking breast cancer in MR imaging. J Magn Reson Imaging. 28(6):1499-505, 2008
                                                                                              13. Goel NB et al: Fibrous lesions of the breast: imaging-pathologic correlation. Radiographics. 25(6):1547-59, 2005
                                                                                              14. You JK et al: Focal fibrosis of the breast diagnosed by a sonographically guided core biopsy of nonpalpable lesions: imaging findings and clinical relevance. J Ultrasound Med. 24(10):1377-84, 2005
                                                                                              15. Shetty MK et al: Sonographic findings in focal fibrocystic changes of the breast. Ultrasound Q. 18(1):35-40, 2002
                                                                                              16. Sklair-Levy M et al: Stromal fibrosis of the breast. AJR Am J Roentgenol. 177(3):573-7, 2001
                                                                                              17. Revelon G et al: Focal fibrosis of the breast: imaging characteristics and histopathologic correlation. Radiology. 216(1):255-9, 2000
                                                                                              18. Harvey SC et al: Fibrous nodules found at large-core needle biopsy of the breast: imaging features. Radiology. 211(2):535-40, 1999
                                                                                              19. Rosen EL et al: Focal fibrosis: a common breast lesion diagnosed at imaging-guided core biopsy. AJR Am J Roentgenol. 173(6):1657-62, 1999
                                                                                              20. Venta LA et al: Imaging features of focal breast fibrosis: mammographic-pathologic correlation of noncalcified breast lesions. AJR Am J Roentgenol. 173(2):309-16, 1999
                                                                                              21. Berg WA et al: Predictive value of specimen radiography for core needle biopsy of noncalcified breast masses. AJR Am J Roentgenol. 171(6):1671-8, 1998
                                                                                              22. Berg WA et al: Lessons from mammographic-histopathologic correlation of large-core needle breast biopsy. Radiographics. 16(5):1111-30, 1996