Cheung Y C, Chen S C, Lee K F, Wan Y L, Ng S H
Department of Diagnostic Radiology, Chang Gung Medical Center at LinKou, 5 Fu-Hsing Street, Tao Yuan Hsien, Taiwan.
J Clin Ultrasound. 2000 Sep;28(7):325-31. doi: 10.1002/1097-0096(200009)28:7<325::aid-jcu2>3.0.co;2-4.
We investigated whether there was a relationship between the sonographic and histologic appearances of medullary carcinomas of the breast to determine whether sonography is helpful in the differentiation of typical and atypical medullary carcinomas.
We retrospectively reviewed the histologic slides and sonograms of 20 patients who had been diagnosed with medullary carcinoma of the breast. We then classified the carcinomas as typical or atypical based on strict histologic criteria. We also evaluated the relationship between sonographic findings and the histologic reclassification.
Eight (40%) of the 20 medullary carcinomas were classified as typical, and 12 (60%) were classified as atypical. On sonography, a smooth outline was visualized in 6 (75%) of the 8 typical medullary carcinomas but in none of the 12 atypical carcinomas. A jagged margin was sonographically visualized in 10 (83%) of the 12 atypical carcinomas, and a focal irregularity in the margin was visualized in 2 (17%) of the 12 atypical carcinomas. Four of the typical medullary carcinomas had posterior enhancement, and 9 of the atypical medullary carcinomas showed retrotumoral shadowing. The difference in tumor-margin regularity between typical and atypical medullary carcinomas was found to be statistically significant (p < 0.001) using the 2-tailed Fisher's exact test.
To prevent overdiagnosis of medullary carcinoma, a thorough pathologic review of the entire tumor is recommended if sonography shows a jagged margin or a margin with focal irregularity.
我们研究了乳腺髓样癌的超声表现与组织学表现之间是否存在关联，以确定超声检查对鉴别典型和非典型髓样癌是否有帮助。
我们回顾性分析了20例已确诊为乳腺髓样癌患者的组织学切片和超声图像。然后根据严格的组织学标准将这些癌分为典型或非典型。我们还评估了超声检查结果与组织学重新分类之间的关系。
20例髓样癌中，8例（40%）被分类为典型，12例（60%）被分类为非典型。在超声检查中，8例典型髓样癌中有6例（75%）可见轮廓光滑，但12例非典型癌中均未见。12例非典型癌中有10例（83%）超声显示边缘呈锯齿状，12例非典型癌中有2例（17%）可见边缘局灶性不规则。4例典型髓样癌有后方增强，9例非典型髓样癌显示肿瘤后方声影。采用双侧Fisher精确检验发现，典型和非典型髓样癌在肿瘤边缘规则性上的差异具有统计学意义（p<0.001）。
为防止髓样癌的过度诊断，如果超声显示边缘呈锯齿状或有局灶性不规则，建议对整个肿瘤进行全面的病理检查。
