Yang Wei Tse, Dryden Mark J, Gwyn Karin, Whitman Gary J, Theriault Richard
Departments of Diagnostic Radiology and Breast Medical Oncology, University of Texas, M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Unit 57, Houston, TX 77030, USA.
Radiology. 2006 Apr;239(1):52-60. doi: 10.1148/radiol.2391050083. Epub 2006 Feb 16.
To retrospectively assess mammography, high-frequency-transducer ultrasonography (US), and color Doppler US for the initial and subsequent evaluation of breast cancer diagnosed and treated with chemotherapy during pregnancy.
A retrospective study of clinical records between January 1989 and December 2003 of women with breast cancer diagnosed and treated with chemotherapy during pregnancy was performed after waiver of informed consent was obtained. The study was approved by an institutional review board and was HIPAA compliant. Mammograms and sonograms were reviewed by two mammographers using the Breast Imaging Reporting and Data System (BI-RADS) mammographic and US lexicon. US assessment of the regional lymph node basins, including the axillary, infraclavicular, internal mammary, and supraclavicular regions, was documented. US was used to evaluate response to therapy in the breast and the regional lymph nodes in women who underwent neoadjuvant chemotherapy.
Twenty-three women with 24 cancers that were imaged prior to surgery with mammography (n = 3), US (n = 4), or mammography and US (n = 17) were included in the study. The histologic diagnosis of the primary tumor was invasive ductal cancer in 22 lesions, and the diagnosis was invasive carcinoma in the two other cancers. The median age in this study was 34 years (range, 24-45 years). Of the 20 women who underwent preoperative mammography, findings were positive for malignancy in 18 of 20 (90%) cancers despite dense breast parenchymal patterns (BI-RADS types 3 and 4). A mass in all 21 cancers (100%) was depicted in the 20 women who underwent breast and nodal US. US correctly depicted axillary metastasis in 15 of 18 women who underwent US nodal assessment. Of the 12 patients who were evaluated for response to chemotherapy, US demonstrated complete response in two patients, partial response in three, stable findings in one, and progression of disease in six.
Breast cancer diagnosed during pregnancy is mammographically evident despite dense parenchymal background. US, when performed, demonstrates all masses and provides information regarding response to neoadjuvant chemotherapy.
回顾性评估乳腺钼靶、高频探头超声（US）及彩色多普勒超声在孕期诊断并接受化疗的乳腺癌的初始及后续评估中的应用。
在获得知情同意豁免后，对1989年1月至2003年12月期间孕期诊断并接受化疗的乳腺癌女性的临床记录进行回顾性研究。该研究经机构审查委员会批准且符合健康保险流通与责任法案（HIPAA）。两位乳腺造影师使用乳腺影像报告和数据系统（BI-RADS）乳腺钼靶和超声术语对乳腺钼靶片和超声图像进行评估。记录对包括腋窝、锁骨下、胸骨旁和锁骨上区域在内的区域淋巴结群的超声评估情况。超声用于评估接受新辅助化疗的女性乳腺及区域淋巴结的治疗反应。
本研究纳入了23名患有24处癌症的女性，她们在手术前接受了乳腺钼靶检查（n = 3）、超声检查（n = 4）或乳腺钼靶和超声检查（n = 17）。原发肿瘤的组织学诊断为22处病变为浸润性导管癌，另外两处癌症诊断为浸润性癌。本研究中的中位年龄为34岁（范围24 - 45岁）。在20名接受术前乳腺钼靶检查的女性中，尽管乳腺实质呈致密型（BI-RADS 3型和4型），20处癌症中有18处（90%）的检查结果为恶性阳性。在20名接受乳腺及淋巴结超声检查的女性中，所有21处癌症（100%）均显示有肿块。在接受超声淋巴结评估的18名女性中，超声正确显示了15名女性的腋窝转移情况。在12名接受化疗反应评估的患者中，超声显示两名患者完全缓解，三名患者部分缓解，一名患者检查结果稳定，六名患者疾病进展。
尽管乳腺实质背景致密，但孕期诊断的乳腺癌在乳腺钼靶检查中仍很明显。超声检查时可显示所有肿块，并提供有关新辅助化疗反应的信息。
