Taira Naruto, Ohsumi Shozo, Takabatake Daisuke, Hara Fumikata, Takashima Seiki, Aogi Kenjiro, Takashima Shigemitsu, Inoue Takeshi, Sugata Shigenori, Nishimura Rieko
Department of Breast and Endocrine Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama 700-8558, Japan.
Jpn J Clin Oncol. 2008 Jun;38(6):419-25. doi: 10.1093/jjco/hyn040. Epub 2008 May 22.
Magnetic resonance imaging mammography is performed to determine the extent of lesions and to detect occult lesions, but preoperative diagnosis by breast computed tomography (CT) is less common.
We performed a retrospective study of detection of mammographically occult multiple lesions using breast CT. The subjects were 407 female patients (median age: 56 years old; median tumor size: 1.9 cm) with breast cancer who underwent preoperative, contrast-enhanced breast CT.
CT detected 73 incidental-enhanced breast nodules (median size: 0.8 cm) in 73 patients that were undetectable by conventional methods. Age, size of the main lesion or laterality of lesions did not differ between patients with and without incidental nodules, but the frequency of mastectomy was significantly higher in those with incidental nodules. Of the 73 incidental nodules, 22 (30%) were in the same quadrant as the main lesion, 26 (36%) were in other quadrants and 25 (34%) were in the opposite breast. On qualitative diagnosis by CT, 48 were suspected to be malignant (66%), 17 benign (23%) and eight non-specific (11%). In histological evaluation of 44 of the 48 nodules suspected to be malignant, 24 were malignant (invasive carcinoma: 22, non-invasive carcinoma: 2); of seven of the 17 nodules suspected to be benign, all were benign; and of three of the eight non-specific nodules, one was non-invasive carcinoma. The discovery rate of clinically and mammographically occult multiple lesions by preoperative breast CT was 6%.
We conclude that breast CT is useful for the detection of occult lesions and choice of surgical procedure.
磁共振成像乳腺造影用于确定病变范围并检测隐匿性病变，但乳腺计算机断层扫描（CT）的术前诊断较少见。
我们对使用乳腺CT检测乳腺钼靶隐匿性多发病变进行了一项回顾性研究。研究对象为407例接受术前对比增强乳腺CT的乳腺癌女性患者（中位年龄：56岁；中位肿瘤大小：1.9厘米）。
CT在73例患者中检测到73个偶然增强的乳腺结节（中位大小：0.8厘米），这些结节用传统方法无法检测到。有无偶然结节的患者在年龄、主要病变大小或病变侧别方面无差异，但有偶然结节的患者乳房切除术的频率显著更高。在这73个偶然结节中，22个（30%）与主要病变在同一象限，26个（36%）在其他象限，25个（34%）在对侧乳房。根据CT定性诊断，48个怀疑为恶性（66%），17个为良性（23%），8个为非特异性（11%）。在48个怀疑为恶性的结节中，44个进行了组织学评估，其中24个为恶性（浸润性癌：22个，非浸润性癌：2个）；在17个怀疑为良性的结节中，7个全部为良性；在8个非特异性结节中，3个中有1个为非浸润性癌。术前乳腺CT对临床和乳腺钼靶隐匿性多发病变的发现率为6%。
我们得出结论，乳腺CT对于检测隐匿性病变和选择手术方式有用。
