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Stromal Fibrosis of the Breast

Miriam Sklair-Levy1, Taube H. Samuels1, C. Catzavelos2,3, Paul Hamilton1 and Rene Shumak1

1 Department of Medical Imaging, University of Toronto, Sunnybrook & Women's College Health Sciences Centre, 2075 Bayview Ave., Toronto, Ontario M4N 3M5, Canada.
2 Department of Pathology, University of Toronto, Sunnybrook & Women's College Health Sciences Centre, Toronto, Ontario M4N 3M5, Canada.
3 Present address: Department of Pathology, McGill University, 3775 University Ave., Montreal, Quebec H3A 2B4, Canada.



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  		Fig. 1. —Stromal fibrosis in 67-year-old woman. Sagittal sonogram shows irregular hypoechoic shadowing in nonpalpable mass, simulating sonographic features of malignancy.

 


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  		Fig. 2A. —51-year-old woman with stromal fibrosis. Sagittal sonogram shows hypoechoic shadowing.

 


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  		Fig. 2B. —51-year-old woman with stromal fibrosis. Transverse sonogram shows wider shadowing than in A, simulating features of postoperative parenchymal scar. Excisional biopsy confirmed stromal fibrosis.

 


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  		Fig. 3A. —41-year-old woman with infiltrating ductal carcinoma. Sagittal sonogram of left upper outer quadrant reveals ill-defined hypoechoic area (arrows) for which diagnosis of stromal fibrosis on sonographically directed core biopsy was considered concordant.

 


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  		Fig. 3B. —41-year-old woman with infiltrating ductal carcinoma. Transverse sonogram 6 months later shows larger ill-defined area of inhomogeneous echoes (arrows) corresponding to enlarging area of clinical concern. Second core biopsy showed infiltrating ductal carcinoma.

 


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  		Fig. 4A. —72-year-old woman with infiltrating lobular carcinoma. Cropped right mediolateral oblique mammogram shows architectural distortion.

 


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  		Fig. 4B. —72-year-old woman with infiltrating lobular carcinoma. Corresponding sonogram reveals irregular hypoechoic area (arrows) considered discordant with core diagnosis of stromal fibrosis. Excisional biopsy proved infiltrating lobular carcinoma.

 

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