Department of Gynecology, CHRU de Tours, Hôpital Bretonneau, 2 Boulevard Tonnellé, 37044 Tours, France; INSERM Unit 1069, Tours, France; François Rabelais University, Tours, France.
Department of Gynecology, CHRU de Tours, Hôpital Bretonneau, 2 Boulevard Tonnellé, 37044 Tours, France; François Rabelais University, Tours, France.
Breast. 2018 Aug;40:4-9. doi: 10.1016/j.breast.2018.03.012. Epub 2018 Apr 14.
The purposes of this study were to evaluate the outcome of women with pure flat atypical atypia (FEA) diagnosed at vacuum-assisted breast biopsy (VABB) targeting microcalcifications and to determine whether clinical, radiological and pathologic parameters are able to predict which lesions will be upgraded to malignancy.
2414 cases of consecutive VABB for microcalcifications using VA 8-, 10- or 11-Gauge stereotactically guided core biopsy performed between January 2005 and December 2011 from two french breast cancer centers were evaluated. Data of women with VABB-diagnosed pure FEA who underwent either excisional surgery or mammographic follow-up were analyzed. Cases with mass lesions or ipsilateral cancers were excluded. Two pathologists (FA,PM) reviewed the results of procedures performed. Clinical, radiological, as well as histological criteria have been studied in order to determine the correlation between these factors and carcinoma underestimation.
This study included 70 cases of pure FEA. Twenty women underwent surgical excision and 50 had clinical and mammographic surveillance only. In three women FEA was upgraded to breast cancer on excision. Clinical and mammographic follow-up for a mean of 56 months ± 27 in the group without excision showed two cancers in the same breast (Intermediate grade DCIS, and invasive ductal carcinoma 84 and 48 months respectively after VABB). Three factors were significantly predictive of underestimation or occurence of cancer for pure FEA when the radiologic lesions are calcifications: age≥ 57 years, radiologic size >10 mm and number of FEA foci ≥4.
本研究旨在评估真空辅助乳房活检（VABB）针对微钙化进行靶向活检诊断为单纯平坦非典型不典型增生（FEA）的女性的结果，并确定临床、放射学和病理学参数是否能够预测哪些病变将升级为恶性肿瘤。
评估了 2005 年 1 月至 2011 年 12 月期间，两个法国乳腺癌中心进行的 2414 例连续 VABB 用于微钙化，采用 8 、 10 或 11-Gauge 立体定向引导空心活检针。分析了 VABB 诊断为单纯 FEA 且行切除术或乳腺 X 线摄影随访的女性患者的病例。排除了有肿块病变或同侧癌症的病例。两位病理学家（FA 、 PM ）对所进行的程序结果进行了回顾。研究了临床、放射学以及组织学标准，以确定这些因素与癌低估之间的相关性。
本研究纳入了 70 例单纯 FEA 患者。20 例女性患者接受了手术切除，50 例患者仅接受了临床和乳腺 X 线摄影监测。在 3 例女性中，FEA 在切除后升级为乳腺癌。在未切除组中，中位随访时间为 56 个月（±27 个月），在该组中，同侧乳房出现了 2 例癌症（VABB 后 84 个月和 48 个月分别为中等级别 DCIS 和浸润性导管癌）。当放射学病变为钙化时，三个因素与单纯 FEA 的低估或癌症发生显著相关：年龄≥57 岁，放射学大小>10mm ，FEA 灶数量≥4 个。
