Department of Radiology and Nuclear Medicine, University Medical Center, Mannheim, Germany.
Breast. 2009 Oct;18(5):327-34. doi: 10.1016/j.breast.2009.09.010.
The purpose of this study was to assess mammographic and sonographic findings in a long-term follow-up (>or=3 years) after breast-conserving surgery (BCS) and IORT, either applied as boost or exclusively. Follow-up-findings of 54 patients were retrospectively evaluated and compared to a control group of 48 patients, treated with BCS and whole-breast radiotherapy. After IORT patients had a higher incidence of fat necroses manifesting as oil cysts in the late follow-up mammograms (n = 31 vs n = 8); furthermore, oil cysts were larger in the IORT group (median 4.5 vs 1.4 cm(2)). In 25 IORT patients the oil cysts arose from partially organized hematomas/seromas, which in this group were generally more frequent (n = 38 vs n = 9) and larger (median 3.6 vs 1.8 cm(2)). After IORT a decreasing incidence of hematomas/seromas was reciprocal to an increasing incidence of oil cysts, and the size of both entities correlated with each other. Liquid lesions with polypoid inner wall thickening on ultrasound, attributed to organized hematomas/seromas or fat necroses, appear more frequently after IORT (n = 15 vs n = 1). In conclusion, IORT is associated with a high incidence of large oil cysts, which arise from likewise large partially organized wound cavities. On ultrasound pronounced partial organization with polypoid inner wall thickening is a frequent finding in those cavities.
本研究旨在评估保乳手术后（BCS）和术中放疗（IORT）长期随访（>或=3 年）后的乳腺 X 线摄影和超声表现，无论是作为局部加量照射还是单独应用。回顾性评估了 54 例患者的随访结果，并与 48 例接受 BCS 和全乳放疗的对照组进行比较。IORT 组患者在晚期随访乳腺 X 线片中出现更高的脂肪坏死发生率，表现为油囊肿（n = 31 与 n = 8）；此外，IORT 组的油囊肿更大（中位数 4.5 与 1.4cm2）。在 25 例 IORT 患者中，油囊肿源于部分已形成的血肿/血清肿，这些患者的血肿/血清肿通常更常见（n = 38 与 n = 9）且更大（中位数 3.6 与 1.8cm2）。IORT 后，血肿/血清肿的发生率下降与油囊肿的发生率增加呈反比，且这两种实体的大小相互关联。超声检查显示，有蒂状内壁增厚的液体病变归因于已形成的血肿/血清肿或脂肪坏死，在 IORT 后更常见（n = 15 与 n = 1）。总之，IORT 与大油囊肿的高发生率相关，这些油囊肿源于同样大的部分已形成的伤口腔。在这些腔中，超声显示明显的部分组织化，伴有蒂状内壁增厚是一种常见的表现。
