O'Connor Victoria, Arena Elizabeth, Albright Joslyn, Brown Nefertiti, O'Connor Ryan, Chung Maureen, DiNome Maggie, Shamonki Jaime
Margie and Robert Petersen Breast Cancer Research Program, Saint John's Health Center, Santa Monica, California, USA.
Am Surg. 2014 Oct;80(10):944-7.
Radiologic-pathologic correlation of lesions diagnosed by magnetic resonance (MR) is precluded by insufficient data on histological characteristics of lesions suspicious on MR but not visible on concurrent mammogram or ultrasound. The objective of this study was to describe histological features of breast lesions diagnosed exclusively by MR. The participants underwent MR-guided breast biopsy between 2007 and 2012 for a suspicious lesion not identified by mammography or ultrasound. Histology slides were interpreted retrospectively by a breast pathologist. Of 126 patients (126 lesions), 34 (27%) had new breast cancer, 51 (40.5%) previous breast cancer, and 41 (32.5%) dense breasts or a significant family history of breast cancer. MR identified 23 (18.3%) invasive cancers: 20 were Grade 1 and 17 were ductal. Of the 126 lesions, 16 (13%) were ductal carcinoma in situ (DCIS), four were atypical ductal hyperplasia and atypical lobular hyperplasia (3%), and 68 (54%) were benign. Fifteen biopsies (12%) had no significant pathology. Five DCIS lesions were upgraded to T1 invasive cancers. Approximately 30 per cent of suspicious lesions detected exclusively by MR are invasive or in situ cancers that are predominantly low grade. Further studies are needed to determine if malignant lesions can be prospectively distinguished by MR characteristics.
磁共振成像（MR）诊断的病变的放射学与病理学相关性，因关于MR可疑但在同期乳房X线摄影或超声检查中不可见的病变的组织学特征的数据不足而无法实现。本研究的目的是描述仅通过MR诊断的乳腺病变的组织学特征。参与者在2007年至2012年期间接受了MR引导下的乳腺活检，针对乳房X线摄影或超声检查未发现的可疑病变。组织学切片由一名乳腺病理学家进行回顾性解读。在126例患者（126个病变）中，34例（27%）患有新发乳腺癌，51例（40.5%）患有既往乳腺癌，41例（32.5%）乳房致密或有显著的乳腺癌家族史。MR识别出23例（18.3%）浸润性癌：20例为1级，17例为导管癌。在126个病变中，16例（13%）为导管原位癌（DCIS），4例为非典型导管增生和非典型小叶增生（3%），68例（54%）为良性病变。15例活检（12%）无显著病理学改变。5例DCIS病变升级为T1期浸润性癌。仅通过MR检测到的可疑病变中，约30%为浸润性癌或原位癌，且主要为低级别。需要进一步研究以确定恶性病变是否可以通过MR特征进行前瞻性区分。
