Rostas Jack W, Bhutiani Neal, Crigger Morgan, Crawford Stacey M W, Hollenbach Reiss B, Heidrich Samantha R, Martin Robert C G, McMasters Kelly M, Ajkay Nicolás
Department of Surgery, Division of Surgical Oncology, University of Louisville, Louisville, Kentucky.
School of Medicine, Department of Radiology, University of Louisville, Louisville, Kentucky.
J Surg Oncol. 2018 Jun;117(8):1848-1853. doi: 10.1002/jso.25076. Epub 2018 May 22.
Accurately assessing breast volume (BV) relative to the volume of breast tissue to be removed could help objectively determine the optimal surgical candidates for breast conserving surgery. The objective of this study was to determine the optimal mammography-based method of BV estimation.
Mammography data was obtained for patients who underwent mastectomy for breast cancer from 2005 to 2015. This data was used to calculate BV using four previously published equations. Results were compared to mastectomy specimen volumes calculated from specimen weights and breast density. Five practitioners then independently assessed reproducibility and ease of use.
Complete mammographic measurements were available for 65 breasts from 45 patients. Median age was 58 years (range 19-82). Mammographic breast density scores were available for 62 breasts. Of the 65 mastectomies performed, 16 (36%) were simple mastectomies. The equation BV = 1/3πR R H most closely approximated actual breast specimen volumes (R = 0.89, P < 0.0001). Internal correlation of calculated BV was excellent among all practitioners (lowest Pearson R = 0.963).
Breast volumes can be reliably estimated utilizing measurements from a preoperative mammogram. This low-cost method of volumetric analysis can be employed to guide surgical decision making in treatment of patients with invasive breast cancer.
准确评估乳房体积（BV）与拟切除乳房组织体积的关系，有助于客观确定保乳手术的最佳手术候选者。本研究的目的是确定基于乳房X线摄影的BV估计的最佳方法。
获取2005年至2015年因乳腺癌接受乳房切除术患者的乳房X线摄影数据。使用四个先前发表的公式计算BV。将结果与根据标本重量和乳房密度计算的乳房切除标本体积进行比较。然后，五名从业者独立评估其可重复性和易用性。
45例患者的65个乳房有完整的乳房X线摄影测量数据。中位年龄为58岁（范围19 - 82岁）。62个乳房有乳房X线摄影乳房密度评分。在进行的65例乳房切除术中，16例（36%）为单纯乳房切除术。公式BV = 1/3πR²H最接近实际乳房标本体积（R = 0.89，P < 0.0001）。所有从业者计算的BV的内部相关性都很好（最低Pearson相关系数R = 0.963）。
利用术前乳房X线摄影测量可可靠地估计乳房体积。这种低成本的体积分析方法可用于指导浸润性乳腺癌患者治疗中的手术决策。
