Objective  To investigate the value of color Doppler sonography in the diagnosis of phyllodes tumors with different pathologic types and in the differential diagnosis of phyllodes tumor and fibroadenoma.

  Methods  The sonographic characteristics of 87 breast phyllodes tumors confirmed by histopathology from Janurary 2005 to December 2009 were retrospectively studied. In addition, 120 breast fibroadenoma confirmed by histopathology between June 2008 and August 2008 were set as the control group. The pathologic results were regarded as the gold standard.

  Results  The patients with phyllodes tumors were older than the patients with fibroadenoma(39.86±9.68) years vs. (34.23±12.33) years; P < 0.05. The diameter of phyllodes tumor was larger than that of fibroadenoma(3.70±2.26) cm vs. (1.92±1.13) cm; P < 0.05. As shown by color Doppler sonography, the shape of the tumor, retrotumor acoustic phenomenon, and cystic area were significantly different between phyllodes tumor and fibroadenoma (P < 0.05). The tumor size and Color Doppler flow grade were independent risk factors of phyllodes tumors (OR=1.36 and 1.82, respectively; both P < 0.05). Benign, borderline, and malignant phyllodes tumors displayed no significantly different sonographic findings.

  Conclusions  There is a substantial overlap in the sonographic characteristics between phyllodes tumors and fibroadenoma. If lobulation, posterior acoustic shadowing, and cystic area are observed under color Doppler sonography, a diagnosis of phyllodes tumor can be considered. Sonography can not distinguish benign, borderline, or malignant phyllodes tumors.