Son Eun Ju, Oh Ki Keun, Kim Eun Kyung
Department of Diagnostic Radiology, Yonsei University College of Medicine, Seodaemun-gu, Seoul 120-752, Korea.
Yonsei Med J. 2006 Feb 28;47(1):34-42. doi: 10.3349/ymj.2006.47.1.34.
In this paper, we evaluate the radiological features of pregnancy-associated breast lesions and discuss the difficulties in diagnosis by imaging. We selected patients who were diagnosed with pregnancy-associated breast lesions during the previous 5 years. All patients complained of palpable lesions in the breast and underwent ultrasonographic (US) examination, the first choice for examination of pregnancy-related breast lesions. Any suspicious lesions found by the US were recommended for a US-guided core biopsy, US-guided fine needle aspiration (FNA), or surgery. Various breast lesions were detected during pregnancy and lactation, including breast cancer, mastitis and abscesses, lactating adenoma, galactoceles, lobular hyperplasia, and fibroadenomas. The imaging features of pregnancy-associated breast lesions did not differ from the features of non-pregnancy-associated breast lesions; however, some pregnancy-associated benign lesions had suspicious sonographic features. A US-guided core biopsy was necessary for differentiating benign from malignant. In patients with breast cancer, the cancer was often advanced at the time of diagnosis. In conclusion, various pregnancy-related breast lesions were detected and the imaging of these lesions had variable findings. Breast ultrasound could be an excellent imaging modality for diagnosis and differentiation between benign and malignant lesions. However, when the imaging results are suspicious, a biopsy should be performed to obtain a pathologic diagnosis.
在本文中，我们评估了妊娠相关乳腺病变的放射学特征，并讨论了影像学诊断的困难。我们选择了在过去5年中被诊断为妊娠相关乳腺病变的患者。所有患者均主诉可触及乳腺病变，并接受了超声（US）检查，这是妊娠相关乳腺病变检查的首选方法。超声发现的任何可疑病变均建议进行超声引导下的粗针活检、超声引导下细针穿刺抽吸（FNA）或手术。在妊娠和哺乳期发现了各种乳腺病变，包括乳腺癌、乳腺炎和脓肿、哺乳期腺瘤、积乳囊肿、小叶增生和纤维腺瘤。妊娠相关乳腺病变的影像学特征与非妊娠相关乳腺病变的特征并无差异；然而，一些妊娠相关的良性病变具有可疑的超声特征。超声引导下的粗针活检对于区分良性和恶性病变是必要的。在乳腺癌患者中，癌症在诊断时往往已处于晚期。总之，检测到了各种与妊娠相关的乳腺病变，这些病变的影像学表现各不相同。乳腺超声可能是诊断以及区分良性和恶性病变的一种极好的影像学检查方法。然而，当影像学结果可疑时，应进行活检以获得病理诊断。
