Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Oncologist. 2014 Jan;19(1):5-15. doi: 10.1634/theoncologist.2013-0323. Epub 2013 Dec 5.
At The University of Texas MD Anderson Cancer Center, we have used sonography (US) extensively for more than 2 decades to refine the local and regional staging of invasive breast cancer. Although magnetic resonance imaging is superior to all other imaging modalities in the measurement of the primary tumor and detection of additional foci of malignancy, in our experience US has shown sufficient accuracy in clinical practice to stage most invasive breast cancers. The exceptions are ill-defined tumors such as invasive lobular cancers and tumors in breasts containing extensive diffuse benign disease. An advantage of US is that multifocality or multicentricity can be confirmed via US-guided fine-needle aspiration within 15 minutes and the information shared immediately with the patient and the breast surgeon or medical oncologist. US has also proved indispensable in the evaluation of lymphatic spread because it can evaluate more nodal basins (e.g., the supraclavicular fossa and low neck) than magnetic resonance imaging can and because it can guide needle biopsy to confirm the status of any indeterminate node (including internal mammary nodes) within minutes.
在德克萨斯大学 MD 安德森癌症中心，我们已经使用超声（US）超过 20 年，以精确评估浸润性乳腺癌的局部和区域分期。尽管磁共振成像在测量原发肿瘤和检测恶性肿瘤的其他病灶方面优于所有其他成像方式，但根据我们的经验，US 在临床实践中已显示出足够的准确性，足以对大多数浸润性乳腺癌进行分期。例外情况是定义不明确的肿瘤，如浸润性小叶癌和弥漫性良性病变广泛存在的乳房中的肿瘤。US 的一个优势是，通过 US 引导的细针抽吸，可以在 15 分钟内确认多灶性或多中心性，并立即与患者和乳腺外科医生或肿瘤内科医生分享信息。US 在评估淋巴扩散方面也不可或缺，因为它可以评估比磁共振成像更多的淋巴结区域（例如锁骨上窝和颈部低位），并且可以引导针吸活检以在数分钟内确认任何不确定淋巴结（包括内乳淋巴结）的状态。
