Deparment of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Eur J Radiol. 2013 Oct;82(10):e556-61. doi: 10.1016/j.ejrad.2013.05.035. Epub 2013 Jul 4.
To investigate the detectability and imaging characteristics of primary tumors according to imaging modalities and to identify clinical features and histological prognostic factors for axillary metastases in patients with small (≤1cm, T1a and T1b) invasive breast cancer.
A total of 221 patients with histologically confirmed small invasive cancers were included for the statistical analysis. At mammography, ultrasonography and MRI, the detectability, and imaging characteristics of primary tumors were compared in patients with or without axillary metastases. Clinical features and histological prognostic factors for axillary metastases were investigated.
Of 221 patients examined, axillary metastasis was found in 42 (19%) at the time of surgery. There was no significant difference in detectability of small tumors using ultrasonography and MRI between patients with and without axillary metastasis. However, mammography had a higher positive rate of primary tumors in patients with axillary metastasis than without metastasis (92.9% vs. 77.1%, p=0.023). Patients with axillary metastasis in small cancers showed more common architectural distortion than negative (p=0.0147) or mass (p=0.0356) on mammography. Clinical features were not different in the two groups. Only lymphovascular invasion was independently associated with axillary metastasis (p=0.0051, 95% CI, 1.527-11.597).
The detectability of small invasive breast cancers among patients with and without axillary metastasis is different with mammography, but not with US and MRI. Lymphovascular invasion is only a predictor for axillary metastasis in small invasive cancers.
根据影像学模式，研究原发性肿瘤的可检测性和影像学特征，并确定小（≤1cm，T1a 和 T1b）浸润性乳腺癌患者腋窝转移的临床特征和组织学预后因素。
共纳入 221 例经组织学证实的小浸润性癌患者进行统计分析。在乳腺钼靶摄影、超声和 MRI 中，比较了有和无腋窝转移患者的原发性肿瘤的可检测性和影像学特征。研究了腋窝转移的临床特征和组织学预后因素。
在 221 例患者中，手术时发现 42 例（19%）腋窝转移。超声和 MRI 检查小肿瘤的可检测性在有和无腋窝转移的患者之间无显著差异。然而，腋窝转移患者的乳腺钼靶摄影原发性肿瘤阳性率高于无转移患者（92.9%比 77.1%，p=0.023）。在乳腺钼靶摄影中，有腋窝转移的小癌症患者比无转移或有肿块的患者更常见结构扭曲（p=0.0147）。两组患者的临床特征无差异。仅淋巴管血管侵犯与腋窝转移独立相关（p=0.0051，95%CI，1.527-11.597）。
有和无腋窝转移的小浸润性乳腺癌患者的可检测性不同，但超声和 MRI 无差异。淋巴管血管侵犯仅是小浸润性癌腋窝转移的预测因素。
