Clinical efficacy analysis of high-intensity focused ultrasound ablation in treating fibroadenomas of different breast gland types: a retrospective study

Background High-Intensity Focused Ultrasound (HIFU) is an emerging non-invasive therapy for breast fibroadenoma. However, its efficacy across different breast glandular types, which may influence acoustic energy deposition, remains underexplored. Objective This study sought to investigate the treatment efficacy of ultrasound (US)-guided HIFU for breast fibroadenoma with respect to different breast gland types. Methods A retrospective analysis was conducted on 201 patients (314 lesions) with biopsy-confirmed breast fibroadenomas treated between January 2024 and November 2024. Patients were stratified into four groups based on the American College of Radiology (ACR) breast composition classification: fatty group (75%). All patients underwent ultrasound-guided HIFU ablation using the JC-200 system (Chongqing Haifu Medical Technology Co., Ltd., China). The baseline characteristics of patients, lesion features of fibroadenomas, relevant parameters during HIFU treatment, follow-up duration, and tumor volume reduction rate (VRR) were recorded and comparatively analyzed. Statistical analyses included One-Way Analysis of Variance (ANOVA) with least significant difference (LSD)-t tests for pairwise comparisons. Results The average surgical power in the loose group (142.8 ± 38.5 W) was significantly higher than that in the fatty group (128.7 ± 23.3 W), mixed group (128.8 ± 36.6 W), and dense group (121.4 ± 39.5 W), with statistically significant differences ( P < 0.05). The post-HIFU treatment average VRRs for the fatty, loose, mixed, and dense groups were 72.9 ± 16%, 61.6 ± 24%, 55 ± 22%, and 49 ± 32%, respectively. LSD-t test analysis revealed statistically significant differences between pairwise comparisons, including fatty vs . loose, fatty vs . mixed, fatty vs . dense, and loose vs . dense groups ( P < 0.05). Conclusion HIFU is a safe and effective treatment for fibroadenomas across different breast gland types. The significantly superior VRR in fatty-type breasts underscores the critical role of preoperative breast gland typing in predicting HIFU outcomes. These findings advocate for the integration of breast density assessment into clinical decision-making to optimize individualized HIFU treatment planning for benign breast tumors.