Radhika S, Hartini B, Norlia A, Suria-Hayati M P, Zulfiqar M A
Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Kuala Lumpur, 56000, Malaysia.
Universiti Kebangsaan Malaysia, Radiology, Jalan Yaacob Latif, Kuala Lumpur, 56000, Malaysia.
Med J Malaysia. 2016 Oct;71(5):282-287.
This study aimed to determine findings of axillary view mammogram (MMG) and ultrasound (USG) of the ipsilateral side in post-mastectomy patients and to document difficulty level in performing the axillary view and patients' pain level during the procedure.
Post-mastectomy patients who had MMG and USG on follow-up during an 18-months period were included. The MMG and USG findings of 183 patients were reviewed and histology results were recorded when available. Radiographers' difficulty and patients' pain level during the axillary view MMG were charted.
On MMG, 172 cases were normal, eight cases were benign (Category 2) and three cases indeterminate (Category 3). On USG, 175 cases were normal, three cases were benign (Category 2) and five cases indeterminate (Category 3). Malignant lesions detected in two out of 183 patients (1%) were metastatic carcinoma in bilateral axillary lymph nodes and leiomyosarcoma at the mastectomy site. These two cases were Category 3 on USG with negative MMG findings. In majority of cases (79%), the radiographer had no difficulty performing the axillary view compared with contralateral MMG. Majority of patients (80%) experienced similar pain during axillary view compared to contralateral MMG.
Follow-up imaging of post-mastectomy patients should include (i) USG of the mastectomy site, both axillary regions, and the contralateral breast, and (ii) MMG of the contralateral side. Ipsilateral axillary view MMG is not necessary.
本研究旨在确定乳房切除术后患者患侧腋窝位乳房X线摄影（MMG）和超声检查（USG）的结果，并记录进行腋窝位检查的难度级别以及检查过程中患者的疼痛程度。
纳入在18个月期间接受随访并进行MMG和USG检查的乳房切除术后患者。回顾了183例患者的MMG和USG检查结果，并在可获得时记录组织学结果。记录放射技师在腋窝位MMG检查时的难度以及患者的疼痛程度。
MMG检查中，172例结果正常，8例为良性（2类），3例结果不确定（3类）。USG检查中，175例结果正常，3例为良性（2类），5例结果不确定（3类）。183例患者中有2例（1%）检测到恶性病变，分别为双侧腋窝淋巴结转移性癌和乳房切除部位平滑肌肉瘤。这2例在USG检查中为3类，MMG检查结果为阴性。在大多数病例（79%）中，与对侧MMG相比，放射技师进行腋窝位检查没有困难。与对侧MMG相比，大多数患者（80%）在腋窝位检查时经历的疼痛相似。
乳房切除术后患者的随访影像学检查应包括：（i）乳房切除部位、双侧腋窝区域及对侧乳房的USG检查，以及（ii）对侧乳房的MMG检查。患侧腋窝位MMG检查并非必要。
