核心针活检中的放射状瘢痕是否是恶性肿瘤的危险因素？一项单中心回顾性研究及对治疗的影响。
Is radial scar on core needle biopsy a risk factor for malignancy? A single-center retrospective review and implications for management.
机构信息
Department of Surgery, Thomas Jefferson University Hospital, Sidney Kimmel Medical College, Philadelphia University and Thomas Jefferson University, Philadelphia, PA, USA.
Sidney Kimmel Medical College, Philadelphia University and Thomas Jefferson University, Philadelphia, PA, USA.
出版信息
Breast J. 2020 Oct;26(10):2011-2014. doi: 10.1111/tbj.13975. Epub 2020 Jul 13.
INTRODUCTION
Reported upgrade rate to malignancy of radial scars (RS) ranges widely (0%-40%) making management controversial.
METHODS
A retrospective chart review was performed on patients with RS on core needle biopsy (CNB). Upgrade rates to malignancy and atypia on surgical excision were evaluated.
RESULTS
Of 127 patients with RS on CNB, 53 were excluded due to malignancy or missing records. Of 74 patients reviewed, 52 (70.3%) had surgical excision with four (7.7%) upgraded to malignancy. Eight patients (10.8%) had atypia with RS on CNB with two (25%) upgraded to malignancy. When isolated RS was on CNB, 2 of 44 (4.5%) upgraded to malignancy while 15 of 44 (34%) had atypia on excision. Of 22 patients (29.7%) who did not have excision, zero developed cancer.
CONCLUSION
We found higher than expected upgrade rates of isolated RS to atypia which can alter management. Additionally, 25% of RS with atypia upgraded to malignancy suggesting these patients are at higher risk.
简介
报道的放射状瘢痕（RS）恶变率差异很大（0%-40%），这使得其管理存在争议。
方法
对接受核心针活检（CNB）的 RS 患者进行了回顾性图表审查。评估了在外科切除时向恶性肿瘤和非典型性升级的发生率。
结果
在 127 例 CNB 有 RS 的患者中，53 例因恶性肿瘤或记录缺失而被排除在外。在回顾的 74 例患者中，52 例（70.3%）接受了外科切除，其中 4 例（7.7%）升级为恶性肿瘤。8 例（10.8%）在 CNB 有非典型性 RS，其中 2 例（25%）升级为恶性肿瘤。当孤立性 RS 在 CNB 上时，44 例中有 2 例（4.5%）升级为恶性肿瘤，而在 44 例中有 15 例（34%）在切除时有非典型性。在未进行切除的 22 例患者（29.7%）中，没有癌症发生。
结论
我们发现孤立性 RS 向非典型性升级的发生率高于预期，这可能会改变管理方式。此外，25%的非典型性 RS 升级为恶性肿瘤，这表明这些患者的风险更高。
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