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18F-氟代脱氧葡萄糖正电子发射断层扫描发现的偶然乳腺病变。

Incidental breast lesions identified by 18F-fluorodeoxyglucose-positron emission tomography.

机构信息

Breast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.

出版信息

Ann Surg Oncol. 2010 Aug;17(8):2119-25. doi: 10.1245/s10434-010-0950-2. Epub 2010 Feb 17.

Abstract

BACKGROUND

Positron emission tomography (PET) scanning is now part of the standard evaluation for patients with a variety of different malignancies. We describe our experience with breast incidentalomas in a large series of PET scans performed for patients without a known history of breast cancer.

MATERIALS AND METHODS

From March 2000 through June 2007, approximately 45,000 PET scans were performed; 163 had breast findings unrelated to the primary malignancy. In 103 of 163 (63%), findings included physiologic variation, lactation, implants, or benign calcifications. Chart review was conducted in the remaining 60 of 163 patients (37%).

RESULTS

In 20 of 60 patients (33%), no additional evaluation was performed due to advanced stage of the primary malignancy; 40 of 60 (67%) underwent additional imaging and evaluation. In 16 of 40 patients (40%), the lesion resolved on repeat PET; the lesion persisted in 10 of 40 (25%). Additional breast imaging was performed in 14 of 40 (35%). In total, 12 of 40 (30%) underwent biopsy; 7 of 40 (18%) were positive for malignancy.

CONCLUSIONS

In our experience, 29% of breast incidentalomas (7 of 24) with persistent imaging findings were malignant. Further evaluation of these lesions should be based on overall clinical status. In patients where results would not change overall management, biopsy may not be warranted.

摘要

背景

正电子发射断层扫描(PET)扫描现已成为多种不同恶性肿瘤患者标准评估的一部分。我们描述了在对无已知乳腺癌病史的患者进行的大量 PET 扫描中,对乳腺意外瘤的经验。

材料和方法

从 2000 年 3 月至 2007 年 6 月,进行了大约 45000 次 PET 扫描;163 次扫描发现与原发性恶性肿瘤无关的乳腺病变。在 163 例中的 103 例(63%)中,发现包括生理性变化、哺乳期、植入物或良性钙化。在其余 163 例中的 60 例(37%)患者中进行了病历回顾。

结果

在 60 例患者中的 20 例(33%)中,由于原发性恶性肿瘤的晚期而未进行进一步评估;60 例中的 40 例(67%)接受了进一步的影像学检查和评估。在 40 例患者中的 16 例(40%)中,病变在重复 PET 上消退;在 40 例中的 10 例(25%)中病变持续存在。对 40 例中的 14 例(35%)进行了额外的乳房成像检查。总共对 40 例中的 12 例(30%)进行了活检;40 例中有 7 例(18%)为恶性。

结论

根据我们的经验,在有持续影像学发现的乳腺意外瘤(24 例中的 7 例)中,有 29%为恶性。对这些病变的进一步评估应基于整体临床状况。在不会改变总体管理结果的患者中,可能不需要进行活检。

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