Weinfurtner R Jared, Patel Bhavika, Laronga Christine, Lee Marie C, Falcon Shannon L, Mooney Blaise P, Yue Binglin, Drukteinis Jennifer S
Department of Diagnostic Imaging, Moffitt Cancer Center, Tampa, FL.
Department of Diagnostic Imaging, Moffitt Cancer Center, Tampa, FL.
Clin Breast Cancer. 2015 Jun;15(3):234-9. doi: 10.1016/j.clbc.2014.12.005. Epub 2014 Dec 24.
Analysis of magnetic resonance imaging-guided breast biopsies yielding high-risk histopathologic features at a single institution found an overall upstage rate to malignancy of 14% at surgical excision. All upstaged lesions were associated with atypical ductal hyperplasia. Flat epithelial atypia and atypical lobular hyperplasia alone or with lobular carcinoma in situ were not associated with an upstage to malignancy.
The purpose of the present study w as to determine the malignancy upstage rates and imaging features of high-risk histopathologic findings resulting from magnetic resonance imaging (MRI)-guided core needle breast biopsies. These features include atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH), flat epithelial atypia (FEA), and lobular carcinoma in situ (LCIS).
A retrospective medical record review was performed on all MRI-guided core needle breast biopsies at a single institution from June 1, 2007 to December 1, 2013 to select biopsies yielding high-risk histopathologic findings. The patient demographics, MRI lesion characteristics, and histopathologic features at biopsy and surgical excision were analyzed.
A total of 257 MRI-guided biopsies had been performed, and 50 yielded high-risk histopathologic features (19%). Biopsy site and surgical excision site correlation was confirmed in 29 of 50 cases. Four of 29 lesions (14%) were upstaged: 1 case to invasive ductal carcinoma and 3 cases to ductal carcinoma in situ. ADH alone had an overall upstage rate of 7% (1 of 14), mixed ADH/ALH a rate of 75% (3 of 4), ALH alone or with LCIS a rate of 0% (0 of 7), and FEA a rate of 0% (0 of 4). Only mixed ADH/ALH had a statistically significant upstage rate to malignancy compared with the other high-risk histopathologic subtypes combined. No specific imaging characteristics on MRI were associated with an upstage to malignancy on the statistical analysis.
MRI-guided breast biopsies yielding high-risk histopathologic features were associated with an overall upstage to malignancy rate of 14% at surgical excision. All upstaged lesions were associated with ADH. FEA and ALH alone or with LCIS were not associated with an upstage to malignancy.
对某单一机构中磁共振成像引导下的乳腺活检进行分析，这些活检产生了高危组织病理学特征，结果发现在手术切除时，恶性肿瘤的总体分期上调率为14%。所有分期上调的病变均与非典型导管增生相关。单纯的扁平上皮异型增生和非典型小叶增生，或与小叶原位癌同时存在时，均与分期上调至恶性肿瘤无关。
本研究的目的是确定磁共振成像（MRI）引导下的乳腺粗针活检所产生的高危组织病理学发现的恶性肿瘤分期上调率及影像学特征。这些特征包括非典型导管增生（ADH）、非典型小叶增生（ALH）、扁平上皮异型增生（FEA）和小叶原位癌（LCIS）。
对某单一机构在2007年6月1日至2013年12月1日期间所有MRI引导下的乳腺粗针活检进行回顾性病历审查以选择产生高危组织病理学发现的活检。分析了患者的人口统计学资料、MRI病变特征以及活检和手术切除时的组织病理学特征。
共进行了257例MRI引导下的活检，其中50例产生了高危组织病理学特征（19%）。50例中有29例确认了活检部位与手术切除部位的相关性。29个病变中有4个（14%）分期上调：1例上调为浸润性导管癌，3例上调为导管原位癌。单纯ADH的总体分期上调率为7%（14例中的1例），ADH/ALH混合的上调率为75%（4例中的3例），单纯ALH或与LCIS同时存在时上调率为0%（7例中的0例），FEA的上调率为0%（4例中的0例）。与其他高危组织病理学亚型合并相比，只有ADH/ALH混合的分期上调至恶性肿瘤的比率具有统计学意义。在统计分析中，MRI上没有特定的影像学特征与分期上调至恶性肿瘤相关。
MRI引导下产生高危组织病理学特征的乳腺活检在手术切除时与恶性肿瘤的总体分期上调率为14%相关。所有分期上调的病变均与ADH相关。单纯FEA和ALH，或与LCIS同时存在时，均与分期上调至恶性肿瘤无关。
Zotero 插件