Shrestha D B, Ravichandran D, Baber Y, Allen S
Bedfordshire and Hertfordshire Breast Screening Unit, Luton & Dunstable Hospital, Luton, Bedfordshire, UK.
Eur J Surg Oncol. 2009 Feb;35(2):156-8. doi: 10.1016/j.ejso.2008.01.032. Epub 2008 Mar 18.
To study the outcome of patients with screen-detected breast lesions in whom preoperative core biopsy (CB), or fine needle aspiration cytology (FNAC), or both were suspicious of malignancy or malignant, but the final histology of the excised lesion was benign.
Thirty-nine patients who fulfilled the above criteria were identified from a prospectively entered database of 192,153 breast screening examinations at the Bedfordshire and Hertfordshire Breast Screening Unit. Thirty-four patients had suspicious or malignant preoperative FNAC and/or CB, and five had FNAC only. Follow-up was mainly by mammograms. Outcome data were collected from hospital case notes and radiology reports.
The median follow-up period was 3 years following excision biopsy. One patient whose excision biopsy histology was atypical ductal hyperplasia developed a mammographically occult carcinoma in the same breast after 24 months. There were no other cancers reported during this time.
The problem of suspicious preoperative needle biopsies with benign excision biopsy is uncommon in the breast screening population. These patients are not at an increased risk of being diagnosed with a carcinoma in the subsequent 3 years and may be discharged back to standard breast screening.
研究术前粗针活检(CB)或细针穿刺细胞学检查(FNAC)或两者均怀疑为恶性或确诊为恶性,但切除病变的最终组织学检查为良性的经筛查发现的乳腺病变患者的结局。
从贝德福德郡和赫特福德郡乳腺筛查单位前瞻性录入的192153例乳腺筛查检查数据库中,确定了39例符合上述标准的患者。34例患者术前FNAC和/或CB结果可疑或为恶性,5例仅行FNAC检查。随访主要通过乳房X线摄影进行。结局数据从医院病历和放射学报告中收集。
切除活检后的中位随访期为3年。1例切除活检组织学检查为非典型导管增生的患者在24个月后同侧乳房发生了乳房X线摄影隐匿性癌。在此期间未报告其他癌症。
术前针吸活检可疑但切除活检为良性的问题在乳腺筛查人群中并不常见。这些患者在随后3年内被诊断为癌症的风险并未增加,可恢复到标准乳腺筛查。