Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University, College of Medicine, Seoul, Korea.
Department of Radiology, Research Institute of Radiological Science, Center for Clinical Imaging Data Science, Yonsei University, College of Medicine, Seoul, Korea.
Ultrasound Med Biol. 2019 Oct;45(10):2623-2633. doi: 10.1016/j.ultrasmedbio.2019.06.420. Epub 2019 Jul 24.
The purpose of this study was to determine whether disease recurrence and intrinsic characteristics of ductal carcinoma in situ (DCIS) are associated with the imaging method of detection in asymptomatic women. This multicenter, retrospective study included 844 women treated for asymptomatic DCIS who had pre-operative mammography and breast ultrasonography (US) studies available. Of the 844 women, 25 (3.0%) developed recurrences. Patients in the US group had significantly lower 5- and 10-y recurrence-free survival (RFS) rates compared with patients in the mammography group (p = 0.011). US-detected DCIS showed significantly lower 5-and 10-y RFS rates compared with mammography-detected DCIS in patients <50 y or with mammographically dense breasts (p = 0.002 and 0.002, respectively). US as the detection modality (hazard ratio [HR]: 4.451; 95% confidence interval [CI]: 1.530, 12.950; p = 0.006) and HER2 positivity (HR: 4.036; 95% CI: 1.438; 11.330; p = 0.008) were significantly associated with recurrence. We concluded that US as the detection modality and HER2 positivity were significantly associated with recurrence in patients treated for asymptomatic DCIS.
本研究旨在确定疾病复发和导管原位癌(DCIS)的内在特征是否与无症状女性的检测成像方法有关。这项多中心、回顾性研究纳入了 844 名接受无症状 DCIS 治疗的女性,这些女性均有术前乳腺 X 线摄影和乳房超声(US)研究资料。在 844 名女性中,有 25 名(3.0%)发生了复发。与乳腺 X 线摄影组相比,US 组的 5 年和 10 年无复发生存率(RFS)显著降低(p=0.011)。在年龄<50 岁或乳腺 X 线摄影致密的患者中,US 检测的 DCIS 与乳腺 X 线摄影检测的 DCIS 相比,5 年和 10 年 RFS 率显著降低(分别为 p=0.002 和 0.002)。作为检测方式的 US(风险比 [HR]:4.451;95%置信区间 [CI]:1.530,12.950;p=0.006)和 HER2 阳性(HR:4.036;95% CI:1.438;11.330;p=0.008)与复发显著相关。我们得出结论,US 作为检测方式和 HER2 阳性与无症状 DCIS 患者的复发显著相关。