Demircioglu Ozlem, Aribal Erkin, Uluer Meral, Ozgen Zerrin, Demircioglu Fatih
Department of Radiology, Marmara University, Istanbul, Turkey.
Department of Radiation Oncology, Marmara University, Istanbul, Turkey.
Curr Med Imaging Rev. 2019;15(6):573-577. doi: 10.2174/1573405614666180821121254.
Radiotherapy after Breast-Conserving Surgery (BCS) is a standard treatment for breast cancer. Currently, surgical clips are used to determine the tumour bed before radiotherapy planning. This study aimed to evaluate the migration of these clips on mammograms.
The study was conducted on 121 females who were treated with radiotherapy after BCS at their first radiologic control examination 6 months after the end of treatment. MLO and CC views of all cases were evaluated regarding the clips. The distance between the surgical scar centre and the centre of the area covered by the clips was measured on both MLO and CC projections and recorded separately. This distance was determined as the clip displacement. A displacement ≤10 mm was recorded as no displacement.
The clips were out of the images and were not evaluated in 45 cases (37.2%) on CC and in 9 cases (7.4%) on MLO projections. There were no clip displacements in 37 (30.6%) cases on CC and in 43 (35.5%) cases on MLO views. The amount of displacement ranged from 11 to 56 mm with a mean of 24.38 mm on CC views, while on MLO projections, displacement ranged from 11 to 66 mm with a mean of 24.42 mm.
A clip displacement of greater than 10 mm was found in 64.5% of cases on MLO views. Therefore, we believe that the reliability of these clips for accurate delineation of the tumour bed in radiotherapy planning is controversial and other methods must be added.
保乳手术（BCS）后放疗是乳腺癌的标准治疗方法。目前，在放疗计划前使用手术夹来确定肿瘤床。本研究旨在评估这些夹子在乳房X线照片上的移位情况。
本研究对121名在保乳手术后接受放疗的女性进行，于治疗结束后6个月进行首次放射学对照检查。对所有病例的MLO位和CC位乳房X线照片进行夹子评估。在MLO位和CC位投影上分别测量手术瘢痕中心与夹子覆盖区域中心之间的距离，并分别记录。该距离被确定为夹子移位。移位≤10 mm记录为无移位。
在CC位上，45例（37.2%）的夹子超出图像范围未进行评估，在MLO位上有9例（7.4%）。CC位上37例（30.6%）病例和MLO位上43例（35.5%）病例无夹子移位。CC位上移位量范围为11至56 mm，平均为24.38 mm，而在MLO位投影上，移位范围为11至66 mm，平均为24.42 mm。
在MLO位上，64.5%的病例夹子移位大于10 mm。因此，我们认为这些夹子在放疗计划中用于准确描绘肿瘤床的可靠性存在争议，必须添加其他方法。
