Paulinelli Régis Resende, Freitas-Júnior Ruffo, Moreira Marise Amaral Rebouças, Moraes Vardeli Alves de, Bernardes-Júnior Júlio Roberto M, Vidal Célio da Silva Rocha, Ruiz Alessandro Naldi, Lucato Miliana Tostes
Department of Gynecology and Obstetrics, School of Medicine, Federal University of Goiás, Goiás, Brazil.
J Ultrasound Med. 2005 May;24(5):635-41. doi: 10.7863/jum.2005.24.5.635.
The purpose of this study was to assess the risk of malignancy for each type of sonographic feature in solid breast nodules.
The study included 304 patients from the Department of Gynecology and Obstetrics of the Federal University of Goiás who had solid breast nodules. A medical trainee, working under the supervision of a preceptor, obtained the sonographic images of the breast, and the features were recorded in a questionnaire. Each sonographic feature was analyzed and compared with the anatomic and pathologic findings after the lesion was excised.
Of the 304 patients included in the study, 292 (96%) had a conclusive diagnosis. Among these women, 216 (74%) had benign tumors and 76 (26%) had malignant tumors. The odds ratio of malignancy in breast nodules, as calculated by multivariate analysis, was as follows: lesions without circumscribed margins, 17.02 (95% confidence interval, 5.28-54.90); lesions with heterogeneous echo texture, 7.70 (2.99-19.84); lesions with thickened Cooper ligaments, 15.61 (1.08-225.10); nodules whose anteroposterior dimension was larger than their width, 3.29 (1.09-9.96); those with an anterior echogenic rim, 2.59 (0.80-8.40); and those with posterior shadowing, 1.57 (0.62-4.01). Among the 133 cases that had all the sonographic features of a benign lesion, 3 nodules (2.3%) had a histologic diagnosis of malignant.
Sonography is a diagnostic method that can help establish the differentiation between benign and malignant solid tumors. A lack of circumscribed margins, heterogeneous echo patterns, thickened Cooper ligaments, and an increased anteroposterior dimension can indicate a higher probability of malignancy in solid breast nodules.
本研究旨在评估实性乳腺结节各类型超声特征的恶性风险。
该研究纳入了戈亚斯联邦大学妇产科的304例患有实性乳腺结节的患者。一名医学实习生在带教老师的监督下获取乳腺超声图像，并将特征记录在问卷中。在病变切除后，对每个超声特征进行分析，并与解剖学和病理学结果进行比较。
在纳入研究的304例患者中，292例（96%）有明确诊断。在这些女性中，216例（74%）患有良性肿瘤，76例（26%）患有恶性肿瘤。通过多因素分析计算得出的乳腺结节恶性比值比如下：无边界清晰的边缘的病变，17.02（95%置信区间，5.28 - 54.90）；回声质地不均匀的病变，7.70（2.99 - 19.84）；库珀韧带增厚的病变，15.61（1.08 - 225.10）；前后径大于宽度的结节，3.29（1.09 - 9.96）；有前部强回声边缘的结节，2.59（0.80 - 8.40）；有后方声影的结节，1.57（0.62 - 4.01）。在具有所有良性病变超声特征的133例病例中，3个结节（2.3%）组织学诊断为恶性。
超声检查是一种有助于鉴别良性和恶性实性肿瘤的诊断方法。无边界清晰的边缘、不均匀的回声模式、库珀韧带增厚以及前后径增加提示实性乳腺结节恶性可能性较高。
