Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan.
Jpn J Radiol. 2009 Dec;27(10):450-4. doi: 10.1007/s11604-009-0370-z. Epub 2009 Dec 25.
To evaluate the results of stereotactic vacuum-assisted breast biopsy of segmental calcifications.
Thirty-nine lesions with segmental calcifications after the exclusion of malignant calcifications of category 5 were evaluated. Calcifications were classified morphologically into small, round, and amorphous calcifications. Lesions in which small round and amorphous calcifications were mixed were classified into small round dominant and amorphous dominant calcifications. The density of distribution of calcifications, heterogeneity in size, and heterogeneity in density were also classified visually, and the correlations of these categories with the biopsy findings were evaluated.
The calcifications were classified into 10 with small round calcifications (26%), 10 with small round calcifications dominant (26%), 12 with amorphous calcifications dominant (30%), and 7 with amorphous calcifications (18%). The pathological findings of biopsy specimens were benign in 27 lesions (69%), borderline in 1 (3%), and malignant in 11 (28%). Lesions with mixed calcifications in which amorphous calcifications were dominant were more often malignant. Lesions with calcifications showing a high distribution density and those with calcifications heterogeneous in density were more often malignant.
Lesions with heterogeneous calcifications are frequently malignant, and biopsy should be considered.
评估立体定向真空辅助乳腺活检术对节段性钙化的诊断结果。
对 39 例经排除 5 类恶性钙化后发现的节段性钙化病变进行评估。钙化形态学上分为小圆形和无定形钙化。小圆和无定形钙化混合存在的病变分为小圆钙化优势型和无定形钙化优势型。钙化分布密度、大小异质性和密度异质性也通过肉眼进行分类,并评估这些分类与活检结果的相关性。
钙化分为 10 例小圆形钙化(26%)、10 例小圆形钙化优势型(26%)、12 例无定形钙化优势型(30%)和 7 例无定形钙化(18%)。27 例(69%)活检标本病理结果为良性,1 例(3%)为交界性,11 例(28%)为恶性。以无定形钙化为主的混合性钙化病变更常为恶性。钙化分布密度高和密度不均的病变更常为恶性。
异质性钙化病变常为恶性,应考虑进行活检。