Sonographic variability of lactating adenoma demonstrated by a longitudinal evaluation of 4 cases

Aim: Lactating adenoma are circumscribed benign breast lesions developing d uring pregnancy or lactation due to overall enhanced proliferation of stero id hormone dependent tissue. Sonography is the method of choice for imaging mainly because of the physiologically dense breast tissue. Which is the pr edictive value of sonography in the diagnosis of lactating adenoma? Are son ographic characteristics dependent on age of gestation or time of lactation ? Which diagnostic procedure should be recommended? Method: We report the l ong time course of four patients with histologically proven (core-needle bi opsy, 16 Gauge) lactating adenoma, first diagnosed during pregnancy, which were followed up sonographically (1997-2000) with real-time B-mode, panoram a-mode (Siescape (R)) and colour-sonography. Results: Demonstrating a high inter- and intraindividual variability the tumors were biggest around partu ritation. Despite ongoing lactation tumors regressed in size, but did not v anish completely even after definite termination of breast feeding. Evaluat ion of sonographical characteristics did not allow to rule out malignancy. Conclusion: Three percent of all breast cancers at childbearing age coincid e with pregnancy and lactation, therefore, an early histologic diagnosis is absolutely necessary. Sonographically guided core-needle biopsies allow to exclude malignancy without negative effects on breast feeding.