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Developing Asymmetric Breast Tissue¹

¹ From the Departments of Radiology (C.W.P., S.A.F.) and Pathology, Anatomy and Cell Biology (J.P.P.), Jefferson Medical College and Thomas Jefferson University Hospital, 132 S 10th St, 7th Fl, Main Bldg, Philadelphia, PA 19107. From the 1997 RSNA scientific assembly. Received April 16, 1998; revision requested June 24; revision received August 5; accepted October 6. Address reprint requests to C.W.P.

PURPOSE: To show that benign asymmetric breast tissue detected mammographically may increase over time.

MATERIALS AND METHODS: Serial mammograms obtained in 21 women with negative physical examination results and mammographically detected developing asymmetric breast tissue were reviewed, and findings were correlated with results of biopsy (n = 16), ultrasonography (US) (n = 8), and contrast material–enhanced magnetic resonance (MR) imaging (n = 3). Five patients who did not undergo biopsy were followed up for 13–84 months. Thirteen of 16 biopsy specimens were reviewed.

RESULTS: At the time of mammographic change, 12 patients without baseline asymmetric tissue had a mean age of 41.7 years and a mean size of asymmetric tissue of 2.4 cm. The mean age of nine patients with baseline asymmetric tissue was 46.9 years. In eight patients, the mean size increase was 2.5 cm. One patient showed increased tissue density but stable size. All US and MR images were negative. Pseudoangiomatous stromal hyperplasia was present in all 13 biopsy specimens reviewed and extensive in 12. No malignancies have been reported in five of the followed-up patients, and two have had continued enlargement of asymmetric tissue.

CONCLUSION: Pseudoangiomatous stromal hyperplasia is a common histopathologic finding in developing asymmetric breast tissue. Follow-up, rather than biopsy, is a management option if benign imaging and clinical criteria are met.

Index terms: Breast, biopsy, 00.1261, 00.1267 • Breast, diseases, 00.319, 00.721, 00.723 • Breast, MR, 00.121412, 00.121415, 00.12143 • Breast neoplasms, 00.319 • Breast, US, 00.1298

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