Park Vivian Youngjean, Kim Eun-Kyung, Kim Min Jung, Yoon Jung Hyun, Moon Hee Jung
Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Ultrasound Med Biol. 2016 Oct;42(10):2367-71. doi: 10.1016/j.ultrasmedbio.2016.06.004. Epub 2016 Jul 18.
An increasing number of radial scars are detected by ultrasound (US), but their management is controversial. This study investigated the upgrade rate in mammographically occult radial scars/complex sclerosing lesions without epithelial atypia at US-guided 14-gauge core needle biopsy in asymptomatic patients. Nineteen mammographically occult benign radial scars/complex sclerosing lesions (median size, 7 mm; range, 3-23 mm) were included. Patients underwent surgical excision (n = 10) or vacuum-assisted excision, with follow-up US at least 6 mo after benign vacuum-assisted excision results (n = 8), or underwent US follow-up for 2 y after core needle biopsy (n = 1). Any cases with change in diagnosis to high-risk lesions or malignancy at excision were considered upgrades. The upgrade rate was 0.0%. Based on US findings, 15.8% (3/19) were Breast Imaging Reporting and Data System (BI-RADS) category 3, 68.4% (13/19) were BI-RADS category 4a and 15.8% (3/19) were BI-RADS category 4b. Follow-up with US can be considered for mammographically occult benign radial scar/complex sclerosing lesions diagnosed by US core needle biopsy in asymptomatic patients.
超声（US）检测到的放射状瘢痕数量日益增多，但其处理方式仍存在争议。本研究调查了无症状患者在超声引导下14G粗针活检时，乳腺钼靶隐匿性放射状瘢痕/无上皮异型性的复杂性硬化性病变的升级率。纳入了19例乳腺钼靶隐匿性良性放射状瘢痕/复杂性硬化性病变（中位大小7mm；范围3 - 23mm）。患者接受了手术切除（n = 10）或真空辅助切除，良性真空辅助切除结果后至少随访6个月（n = 8），或在粗针活检后接受2年的超声随访（n = 1）。任何在切除时诊断改变为高危病变或恶性肿瘤的病例均视为升级。升级率为0.0%。根据超声检查结果，15.8%（3/19）为乳腺影像报告和数据系统（BI-RADS）3类，68.4%（13/19）为BI-RADS 4a类，15.8%（3/19）为BI-RADS 4b类。对于无症状患者经超声粗针活检诊断为乳腺钼靶隐匿性良性放射状瘢痕/复杂性硬化性病变，可考虑超声随访。
