Çakır Murat, Küçükkartallar Tevfik, Tekin Ahmet, Selimoğlu Nebil, Poyraz Necdet, Belviranlı Mehmet Metin, Kartal Adil
Department of General Surgery, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey.
Department of Plastic and Reconstructive Surgery, Selçuk University Faculty of Medicine, Konya, Turkey.
Ulus Cerrahi Derg. 2015 Jun 1;31(2):68-71. doi: 10.5152/UCD.2015.2929. eCollection 2015.
Mammography may have some limitations in the diagnosis and screening of breast cancer for women who have previously undergone breast reduction surgery. This study aimed to investigate how the structural defects in the breast tissue formed by postoperative changes are reflected on mammography.
The records of patients who had previously undergone breast reduction surgery and who were requested to undergo mammography for breast cancer screening by the general surgery clinic were retrospectively studied. The patients' ages, surgical procedures, postoperative follow-up periods, amount of removed material, and histopathological and mammographic results were studied. The patients were classified into 3 groups: those older than 40 years who underwent reduction mammoplasty targeting predominantly the glandular tissue (group 1), those younger than 40 years who underwent reduction mammoplasty targeting predominantly the fat tissue (group 2), and those older than 40 years who were diagnosed with breast hypertrophy and were not operated (group 3).
The mean follow-up period of the patients was 6 (2-10) years. The mean value of resected tissue was 1120 g (680-2070) in group 1 and 1220 g (720-1980) in group 2. The mean age at the time of surgery was 45 (40-70) years for group 1 and 35 (24-40) years for group 2. All patients in group 1 were classified in Breast Imaging-Reporting and Data System (BI-RADS) category 1-2; 28 patients in group 2 were classified in BI-RADS 1-2, 4 were classified in BI-RADS 3, and 8 were classified in BI-RADS 0. In group 3, 35 patients were classified in BI-RADS 1-2, 4 were classified in BI-RADS 3, and 1 was classified in BI-RADS 0.
We believe that breast reduction surgery targeting predominantly the glandular tissue in patients older than 40 years increases mammographic sensitivity.
对于既往接受过乳房缩小手术的女性,乳腺钼靶摄影在乳腺癌诊断和筛查中可能存在一些局限性。本研究旨在探讨术后改变所形成的乳腺组织结构缺陷在乳腺钼靶摄影上是如何体现的。
回顾性研究既往接受过乳房缩小手术且被普通外科门诊要求进行乳腺癌筛查乳腺钼靶摄影的患者记录。研究患者的年龄、手术方式、术后随访时间、切除组织量以及组织病理学和乳腺钼靶摄影结果。将患者分为3组:年龄大于40岁、主要针对腺体组织进行乳房缩小成形术的患者(第1组);年龄小于40岁、主要针对脂肪组织进行乳房缩小成形术的患者(第2组);被诊断为乳房肥大但未接受手术的年龄大于40岁的患者(第3组)。
患者的平均随访时间为6(2 - 10)年。第1组切除组织的平均重量为1120 g(680 - 2070),第2组为1220 g(720 - 1980)。第1组手术时的平均年龄为45(40 - 70)岁,第2组为35(24 - 40)岁。第1组所有患者的乳腺影像报告和数据系统(BI - RADS)分类为1 - 2类;第2组28例患者分类为BI - RADS 1 - 2类,4例分类为BI - RADS 3类,8例分类为BI - RADS 0类。第3组中,35例患者分类为BI - RADS 1 - 2类,4例分类为BI - RADS 3类,1例分类为BI - RADS 0类。
我们认为,对于年龄大于40岁的患者,主要针对腺体组织进行乳房缩小手术可提高乳腺钼靶摄影的敏感性。