VGH-HT Imaging Center, Taipei, Taiwan, ROC.
Oncology. 2012;82(2):98-107. doi: 10.1159/000335958. Epub 2012 Feb 11.
This study investigated one-stop breast screening combining magnetic resonance imaging (MRI) and ultrasound (US) in asymptomatic Asian women.
3,586 asymptomatic women (mean age, 45.3 years) were retrospectively analyzed by breast MRI followed by US. US-guided biopsy was performed when the MRI-detected lesion was confirmed by US. When the lesion was not detected on the initial US, a second-look US guided by MRI findings was performed. Then biopsy was done. MRI-positive and US-negative patients were followed up according to MRI lesion size, MRI lesion morphology, and mammographic diagnosis.
In total, 115 subjects had suspicious malignant lesions and received US-guided biopsy, and 47 malignant lesions, including 35 invasive cancers and 12 carcinoma in situ (CIS) lesions, were diagnosed. More than half (22/35, 63%) of the women with invasive cancer were <50 years of age, and 27 (57.4%) of the 47 cancer cases had early breast cancers. Two invasive cancers (5.7%) and 7 CIS lesions (58.3%) were found at the second-look US. The overall cancer incidence was 1.31% (47/3,586) and increased to 2.2% (78/3,586) if precancerous lesions were included. Subjects aged 41-50 years had the highest incidence of cancer detection (1.97%). Five MRI and US-negative cases had cancers found 1 year after the screening.
The results from the one-stop breast screening in this study showed that combining MRI and US is an efficient multimodality tool for screening asymptomatic Asian women in a metropolitan area of Taiwan who had concerns about the diagnosis and radiation of mammography.
本研究调查了在无症状亚洲女性中结合磁共振成像（MRI）和超声（US）的一站式乳房筛查。
回顾性分析了 3586 名无症状女性（平均年龄 45.3 岁）的乳腺 MRI 检查结果，随后进行了 US 检查。当 MRI 检测到的病变在 US 上得到确认时，进行 US 引导下活检。当初始 US 上未检测到病变时，根据 MRI 结果进行第二次 US 引导活检。然后进行活检。根据 MRI 病变大小、MRI 病变形态和乳房 X 线摄影诊断对 MRI 阳性和 US 阴性患者进行随访。
共有 115 例患者有可疑恶性病变，并接受了 US 引导下活检，诊断出 47 例恶性病变，包括 35 例浸润性癌和 12 例原位癌（CIS）病变。超过一半（22/35，63%）的浸润性癌患者年龄<50 岁，47 例癌症中有 27 例（57.4%）为早期乳腺癌。第二次 US 检查发现 2 例浸润性癌（5.7%）和 7 例 CIS 病变（58.3%）。总的癌症发病率为 1.31%（47/3586），如果包括癌前病变则增至 2.2%（78/3586）。年龄在 41-50 岁的患者癌症检出率最高（1.97%）。5 例 MRI 和 US 均为阴性的患者在筛查后 1 年发现癌症。
本研究的一站式乳房筛查结果表明，在台湾一个都会区，对于那些对乳房 X 线摄影的诊断和辐射有顾虑的无症状亚洲女性，结合 MRI 和 US 是一种高效的多模态筛查工具。
