Department of Surgical Oncology, Tohoku University Graduate School of Medicine, Miyagi, Japan.
Cancer Sci. 2011 Dec;102(12):2179-85. doi: 10.1111/j.1349-7006.2011.02088.x. Epub 2011 Oct 6.
The present study retrospectively evaluated the mammographic findings of 606 Japanese women with breast cancer (median age 50 years; range 27-89 years) and correlated them with histopathological characteristics. Mammographic findings were evaluated with an emphasis on mass shape, margin, density, calcification, and the presence of architectural distortion; these findings were correlated with histopathological characteristics such as intrinsic subtype, histological grade, lymphovascular invasion, and the Ki-67 labeling index. An irregular mass shape and masses with a spiculated margin were significantly higher in the group of patients with luminal A breast cancer than in patients with masses that were lobular or round, or in tumors with an indistinct or microlobulated periphery (P = 0.017, P = 0.024, P < 0.001, and P = 0.001, respectively). Irregular mass shape and spiculated periphery were significantly lower in patients with Grade 3 cancer (P < 0.001 for both). In terms of lymphovascular invasion, there were significant differences between oval and irregular or round mass shape (P = 0.008 and P = 0.034), between tumors with a microlobulated and indistinct periphery (P = 0.014), between tumors with a punctate and amorphous or pleomorphic calcification shape (P = 0.030 and 0.038), and between the presence and absence of architectural distortion (P = 0.027). Equivalent or low-density masses were also higher in Grade 1 breast cancers (P = 0.007). There were significant differences in the Ki-67 labeling index between irregular and lobular or round tumors (P < 0.001 and P = 0.014), as well as between spiculated and indistinct or microlobulated tumors (P < 0.001 for both). Significant differences were noted in the mammographic features of different primary breast cancer subtypes. These proposed mammographic diagnostic criteria based on biological characteristics may contribute to a more accurate prediction of biological behavior of breast malignancies.
本研究回顾性评估了 606 例日本女性乳腺癌患者（中位年龄 50 岁；范围 27-89 岁）的乳腺 X 线摄影表现，并将其与组织病理学特征相关联。乳腺 X 线摄影表现评估重点关注肿块形态、边缘、密度、钙化和结构扭曲的存在；这些发现与内在亚型、组织学分级、淋巴管侵犯和 Ki-67 标记指数等组织病理学特征相关联。不规则肿块形态和有毛刺状边缘的肿块在 luminal A 型乳腺癌患者中明显高于具有小叶或圆形肿块或边界不清晰或微小叶状的肿瘤（P = 0.017，P = 0.024，P < 0.001 和 P = 0.001）。3 级癌症患者中不规则肿块形态和毛刺状边缘明显较低（均 P < 0.001）。就淋巴管侵犯而言，椭圆形和不规则或圆形肿块形态之间（P = 0.008 和 P = 0.034）、边界不清晰或微小叶状和边界微小叶状或不清晰的肿瘤之间（P = 0.014）、点状和无定形或多形性钙化形状和形态不规则或圆形肿块之间（P = 0.030 和 0.038）以及结构扭曲的存在和不存在之间（P = 0.027）存在显著差异。1 级乳腺癌中也存在等密度或低密度肿块（P = 0.007）。不规则和小叶或圆形肿瘤之间的 Ki-67 标记指数存在显著差异（均 P < 0.001 和 P = 0.014），以及毛刺状和不清晰或微小叶状肿瘤之间存在显著差异（均 P < 0.001）。不同原发性乳腺癌亚型的乳腺 X 线摄影特征存在显著差异。这些基于生物学特征的拟议的乳腺 X 线摄影诊断标准可能有助于更准确地预测乳腺癌的生物学行为。
