Advanced Ultrasound in Diagnosis and Therapy ›› 2022, Vol. 6 ›› Issue (4): 195-203.doi: 10.37015/AUDT.2022.220003

• Original Research • Previous Articles     Next Articles

Performance of Elastography, Color Doppler and B Mode Ultrasound to Differentiate Fibroadenomas from Phyllodes Tumors

Lynda Aoudiaa,*(), Amal Kouchkarb, Salah Eddine Bendiba   

  1. a Department of Radiology, Pierre and Marie Curie Center, University Algiers 1, Algeria
    b Department of Pathology, Pierre and Marie Curie Center, University Algiers 1, Algeria
  • Received:2022-02-12 Revised:2022-03-05 Accepted:2022-03-24 Online:2022-12-30 Published:2022-10-25
  • Contact: Lynda Aoudia,


Objective: To evaluate and compare the diagnostic performance of B-mode ultrasound (B-mode US), strain elastography (SE), color Doppler ultrasound (color Doppler US) and the combination of these modalities in differentiation between fibroadenomas and phyllodes tumors.

Methods: This retrospective study included 220 breast lesions, between January 2016 and January 2018. B-mode US, strain elastography, and color Doppler US were realized to evaluate each lesion. The results of three modalities were compared between the B-mode US and the combination of B-mode US, elastography, and color Doppler US: sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic curve (AUC). The pathological findings were used as the reference standard.

Results: Among 220 breast masses, 189 of the lesions were fibroadenomas, 31 were phyllodes tumors. Addition of strain elastography and color Doppler US to B-mode US increased the specificity from 27.5% (95% confidence interval [CI]: 21.15%, 33.88%) to 95.24% (95% CI: 92.20%, 98.27%; P < 0.001); PPV from 16.46% (95% CI: 10.79%,22.14%) to 60.87% (95% CI: 40.92%, 80.82%; P < 0.001) and AUC from 0.584 (95% CI: 0.481, 0.687) to 0.886 (95% CI: 0.824, 0.948; P < 0.001).

Conclusion: The combination B-mode US, strain elastography and color Doppler US increase the diagnostic performance in distinguishing fibroadenomas from phyllodes tumors.

Key words: Breast; Elastography; Ultrasound; Color Doppler; Fibroadenoma; Phyllodes tumor