Myers Kelly S, Kamel Ihab R, Macura Katarzyna J
Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Hospital, Baltimore, MD.
Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Hospital, Baltimore, MD.
Clin Breast Cancer. 2015 Apr;15(2):143-52. doi: 10.1016/j.clbc.2014.11.003. Epub 2014 Nov 10.
The purpose of this study was to correlate the pathology results of MRI-guided breast biopsies at our institution with MRI findings and patient clinical history characteristics. The effect of MRI-guided breast biopsies on surgical management in patients with a new diagnosis of breast cancer was also assessed.
In this Health Insurance Portability and Accountability Act-compliant study we retrospectively reviewed all MRI-guided breast biopsies performed from March 2006 to May 2012. Clinical history, MRI features, and pathology outcomes were reviewed. In patients who underwent breast MRI to evaluate extent of disease, any change in surgical management resulting from the MRI-guided biopsy was recorded. Statistical analysis included binary logistic regression and independent Student t test.
Two-hundred fifteen lesions in 168 patients were included, of which 23 (10.7%) were malignant, 43 (20%) were high-risk, and 149 (69.3%) were benign. No clinical characteristic was associated with malignancy in our cohort. MRI features associated with malignancy were: larger size (mean 2.6 cm vs. 1.3 cm; P = .046), washout kinetics (18% malignancy rate; P = .02), and marked background parenchymal enhancement (40% malignancy rate; P < .001-.03). Nineteen (28%) of the 67 patients with a new diagnosis of breast cancer who underwent MRI-guided breast biopsy had a change in surgical management based on the biopsy result.
Malignancy rate was associated with lesion size, washout kinetics, and marked background enhancement of the breast parenchyma but was not associated with any clinical history characteristics. Preoperative MRI-guided breast biopsies changed surgical management in 28% of women with a new diagnosis of breast cancer.
本研究的目的是将我们机构中MRI引导下乳腺活检的病理结果与MRI表现及患者临床病史特征相关联。同时还评估了MRI引导下乳腺活检对新诊断乳腺癌患者手术治疗的影响。
在这项符合《健康保险流通与责任法案》的研究中，我们回顾性分析了2006年3月至2012年5月期间所有接受MRI引导下乳腺活检的患者。对临床病史、MRI特征和病理结果进行了回顾。在接受乳腺MRI检查以评估疾病范围的患者中，记录了MRI引导下活检导致的手术治疗的任何变化。统计分析包括二元逻辑回归和独立样本t检验。
纳入了168例患者的215个病灶，其中23个（10.7%）为恶性，43个（20%）为高危，149个（69.3%）为良性。在我们的队列中，没有临床特征与恶性肿瘤相关。与恶性肿瘤相关的MRI特征为：更大的尺寸（平均2.6 cm对1.3 cm；P = 0.046）、廓清动力学（恶性率18%；P = 0.02）和明显的背景实质强化（恶性率40%；P < 0.001 - 0.03）。在67例新诊断为乳腺癌并接受MRI引导下乳腺活检的患者中，19例（28%）基于活检结果改变了手术治疗。
恶性率与病灶大小、廓清动力学和乳腺实质的明显背景强化相关，但与任何临床病史特征无关。术前MRI引导下乳腺活检使28%新诊断为乳腺癌的女性改变了手术治疗。
