Chung S Y, Oh K K
Department of Diagnostic Radiology, Pundang CHA General Hospital, Pochon CHA University, College of Medicine, 351 Yatap-Dong, Pundang-Gu, Sungnam, Kyonggido 463-712, Korea.
Yonsei Med J. 2001 Oct;42(5):497-502. doi: 10.3349/ymj.2001.42.5.497.
The purpose of this study was to evaluate imaging findings of metastatic disease to the breast. We analyzed 15 cases that had been previously examined by radiographic study (comprising a total of 11 mammograms, 13 ultrasounds and 3 chest CT). Primary malignancies included the following: 6 breast cancers, 5 stomach cancers, 2 melanomas, 1 cervical cancer, and 1 lung cancer. Radiologic findings were analyzed and the 15 cases were divided into two groups: hematogeneous and lymphangitic metastasis. Eleven cases were classified as lymphangitic metastasis (73.3%) and 4 cases were hematogeneous metastasis (26.7%). Multiple masses were shown in 13 cases (86.7%), and 12 cases displayed unilateral lesions (80%). There was no evidence of calcification. In the 11 cases with available mammogram, 7 cases (63.6%) revealed multiple masses with well-defined (2 cases, 28.6%) or ill-defined margin (5 cases, 71.4%) and 6 cases (54.5%) showed diffuse increased density and skin thickening. Among the 11 cases that revealed mass lesions on ultrasound, 2 cases showed a well-defined margin (18.2%) and 9 cases showed an ill-defined margin (81.8%). Posterior shadowing of the mass was seen in only 1 case. Four cases (36.3%) showed a minimal echogenic boundary around the mass. Eight cases showed diffuse skin thickening (53.3%). Three cases with chest CT showed multiple masses and/or diffuse skin and trabecular thickening of the breast. In conclusion, the characteristic imaging findings of metastatic disease to the breast are multiple ill-defined masses with a lack of desmoplastic reaction and no calcification, as compared to primary breast carcinoma. The diffuse lesions without evidence of breast mass on mammogram and US could be distinguishable from inflammatory carcinoma of breast origin.
本研究的目的是评估乳腺转移性疾病的影像学表现。我们分析了15例先前接受过影像学检查的病例（包括11例乳房X线摄影、13例超声检查和3例胸部CT）。原发性恶性肿瘤包括：6例乳腺癌、5例胃癌、2例黑色素瘤、1例宫颈癌和1例肺癌。分析了放射学表现，并将这15例病例分为两组：血行转移和淋巴管转移。11例被分类为淋巴管转移（73.3%），4例为血行转移（26.7%）。13例（86.7%）显示多发肿块，12例（80%）表现为单侧病变。没有钙化的证据。在11例有乳房X线摄影资料的病例中，7例（63.6%）显示多发肿块，边界清晰（2例，28.6%）或边界不清（5例，71.4%），6例（54.5%）表现为弥漫性密度增加和皮肤增厚。在11例超声显示肿块病变的病例中，2例边界清晰（18.2%），9例边界不清（81.8%）。仅1例可见肿块后方声影。4例（36.3%）在肿块周围可见微小的回声边界。8例显示弥漫性皮肤增厚（53.3%）。3例胸部CT显示乳房多发肿块和/或弥漫性皮肤及小梁增厚。总之，与原发性乳腺癌相比，乳腺转移性疾病的特征性影像学表现为多发边界不清的肿块，缺乏促纤维组织增生反应且无钙化。乳房X线摄影和超声检查中无乳房肿块证据的弥漫性病变可与乳腺源性炎性癌相鉴别。
