Yoon Ga Young, Cha Joo Hee, Kim Hak Hee, Shin Hee Jung, Chae Eun Young, Choi Woo Jung
Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Ultrasonography. 2018 Apr;37(2):149-156. doi: 10.14366/usg.17036. Epub 2017 Aug 4.
Our study investigated whether any sonographic findings could be useful for differentiating between small triple-negative breast cancer (TNBC) and fibroadenoma.
This retrospective study was approved by our Institutional Review Board, which waived the requirement for patient consent. From January 2009 to December 2010, the sonographic features of 181 pathologically proven TNBC tumors and 172 fibroadenomas measuring less than or equal to 2 cm in the longest dimension were reviewed and analyzed according to the fifth edition of the Breast Imaging Reporting and Data System (BI-RADS) lexicon. Mean tumor roundness was also measured using in-house software.
The median longest lesion dimension was 16 mm (range, 13 to 18 mm) in TNBCs and 13 mm (range, 10 to 16 mm) in fibroadenomas. In comparison to fibroadenomas, small TNBC tumors presented with a higher incidence of irregular shapes (66.9%), noncircumscribed margins (91.7%), hypoechoic echotexture (59.1%), posterior acoustic enhancement (65.2%), and associated features (24.4%). Most TNBCs were classified as BI-RADS category 4 (65.2%) or 5 (28.2%). The mean tumor roundness of small TNBCs was greater than that of fibroadenomas (60%±12% vs. 53%±13%). Multivariate analysis showed that older patient age, irregular shape, nonparallel orientation, posterior acoustic enhancement, associated features, a BI-RADS final assessment category of 4 or 5, and greater tumor roundness were significant independent factors indicative of TNBCs.
TNBC tumors tend to demonstrate more suspicious sonographic features and greater tumor roundness than fibroadenomas. These features may have the potential to help differentiate between small TNBCs and fibroadenomas.
我们的研究调查了是否有任何超声检查结果可用于鉴别小的三阴性乳腺癌（TNBC）和纤维腺瘤。
这项回顾性研究经我们机构审查委员会批准，该委员会免除了患者知情同意的要求。2009年1月至2010年12月，根据《乳腺影像报告和数据系统（BI-RADS）》第五版词汇表，对181例经病理证实的TNBC肿瘤和172例最大径小于或等于2 cm的纤维腺瘤的超声特征进行了回顾和分析。还使用内部软件测量了肿瘤的平均圆度。
TNBC的病变最长径中位数为16 mm（范围13至18 mm），纤维腺瘤为13 mm（范围10至16 mm）。与纤维腺瘤相比，小的TNBC肿瘤具有更高的不规则形状发生率（66.9%）、非边缘清晰的边界（91.7%）、低回声质地（59.1%）、后方回声增强（65.2%）以及相关特征（24.4%）。大多数TNBC被分类为BI-RADS 4类（65.2%）或5类（28.2%）。小TNBC的平均肿瘤圆度大于纤维腺瘤（60%±12%对53%±13%）。多变量分析显示，患者年龄较大、形状不规则、非平行方向、后方回声增强、相关特征、BI-RADS最终评估类别为4或5以及更大的肿瘤圆度是提示TNBC的显著独立因素。
与纤维腺瘤相比，TNBC肿瘤往往表现出更可疑的超声特征和更大的肿瘤圆度。这些特征可能有助于鉴别小的TNBC和纤维腺瘤。
