Yilmaz E, Lebe B, Balci P, Sal S, Canda T
Department of Radiology, Dokuz Eylül University Hospital, Izmir, Turkey.
Clin Radiol. 2002 Jul;57(7):640-5. doi: 10.1053/crad.2001.0902.
The aim of this study was to describe the contribution of mammographic and sonographic findings to the discrimination of typical and atypical histopathologic groups of medullary carcinomas of the breast.
Imaging findings were retrospectively assessed in 33 women with medullary carcinomas (15 typical medullary carcinomas and 18 atypical medullary carcinomas) identified during pre-operative mammography. Twenty-nine of these women also had ultrasound and these findings were reviewed.
Mammography showed a well circumscribed mass in 10 of the 15 (67%) typical medullary carcinomas and in four of the 17 (24%) atypical medullary carcinomas (P < 0.02). One small tumour in a woman with atypical medullary carcinoma was missed on mammography and was shown only on sonography. Sonographically, an irregular margin surrounding the whole mass or part of it was seen in three out of 14 (21%) patients with typical medullary carcinoma and in nine out of 15 (60%) patients with atypical medullary carcinomas (P < 0.05). Posterior acoustic shadowing was more often observed in the typical medullary carcinoma group than in atypical medullary carcinoma and the difference was found to be statistically significant (P < 0.05). None of the other mammographic and sonographic findings were sufficiently characteristic to allow for a differentiation between two groups.
When typical medullary carcinomas were compared with atypical medullary carcinomas according to imaging features, they tended to be well circumscribed masses on both mammography and sonography, and a posterior acoustic shadow was not found on sonography. However, the imaging findings in these two subgroups often resembled each other and histopathology will always be required to confirm the diagnosis.
本研究旨在描述乳腺钼靶和超声检查结果对鉴别乳腺髓样癌典型和非典型组织病理学类型的作用。
回顾性评估33例术前钼靶检查确诊的髓样癌女性患者（15例典型髓样癌和18例非典型髓样癌）的影像学表现。其中29例患者还进行了超声检查，并对检查结果进行了回顾。
钼靶检查显示，15例典型髓样癌中有10例（67%）表现为边界清晰的肿块，17例非典型髓样癌中有4例（24%）表现为边界清晰的肿块（P<0.02）。1例非典型髓样癌女性患者的小肿瘤在钼靶检查中漏诊，仅在超声检查中显示。超声检查显示，14例典型髓样癌患者中有3例（21%）整个肿块或部分肿块边缘不规则，15例非典型髓样癌患者中有9例（60%）整个肿块或部分肿块边缘不规则（P<0.05）。典型髓样癌组比非典型髓样癌组更常观察到后方声影，差异有统计学意义（P<0.05）。其他钼靶和超声检查结果均无足够特征性来区分两组。
根据影像学特征将典型髓样癌与非典型髓样癌进行比较时，它们在钼靶和超声检查中往往表现为边界清晰的肿块，超声检查未发现后方声影。然而，这两个亚组的影像学表现常相似，确诊仍需组织病理学检查。
