Department of Pathology, University of California San Diego, La Jolla, CA, 92037, United States.
Department of Pathology, University of California San Diego, La Jolla, CA, 92037, United States.
Hum Pathol. 2021 May;111:92-97. doi: 10.1016/j.humpath.2021.03.003. Epub 2021 Mar 13.
Nonmass enhancement (NME) on breast magnetic resonance imaging (MRI) is defined as an area whose internal enhancement characteristics can be distinguished from the normal surrounding breast parenchyma, without an associated mass in the Breast Imaging Reporting and Data System lexicon. In this study, we evaluated the pathologic correlates of NME lesions of the breast identified on MRI at our institution, including the frequency of atypical or malignant lesions in the core needle biopsies (CNBs), performed after such a radiologic finding. A retrospective study was performed on all CNBs performed for NME on breast MRI between 2010 and 2019. A total of 443 biopsies from 411 patients were identified, comprising 5.5% of all CNBs over the study period. The pathologic diagnoses were benign in the majority of the biopsies (68.0%), whereas 11.5% and 20.5% of the cases were atypical and malignant lesions, respectively. Of the malignant cases, 69.2% were ductal carcinoma in situ (DCIS) and 30.8% were invasive carcinomas. The most common invasive cancer was invasive ductal carcinoma (50%), followed by invasive lobular carcinoma (39.3%). NME identified on breast MRI carried a significant (32%) risk of atypia and malignancy in our cohort, which confirms that biopsy evaluation of these lesions is warranted. DCIS was the most commonly identified malignancy. Notably, among invasive cancers, invasive lobular carcinoma was identified at a substantially higher frequency that would be expected for that histotype.
磁共振成像（MRI）上的非肿块强化（NME）定义为其内部强化特征可与正常周围乳腺实质区分开来的区域，在乳腺影像报告和数据系统词汇中没有相关的肿块。在本研究中，我们评估了我院 MRI 上识别的乳腺 NME 病变的病理相关性，包括在这种影像学发现后进行的核心针活检（CNB）中典型或恶性病变的频率。对 2010 年至 2019 年间因乳腺 MRI 上的 NME 而行 CNB 的所有患者进行了回顾性研究。共确定了 411 名患者的 443 次活检，占研究期间所有 CNB 的 5.5%。大多数活检的病理诊断为良性（68.0%），而 11.5%和 20.5%的病例分别为不典型和恶性病变。在恶性病例中，69.2%为导管原位癌（DCIS），30.8%为浸润性癌。最常见的浸润性癌是浸润性导管癌（50%），其次是浸润性小叶癌（39.3%）。在我们的队列中，MRI 上识别的 NME 具有显著的（32%）不典型和恶性风险，这证实了对这些病变进行活检评估是合理的。DCIS 是最常见的恶性肿瘤。值得注意的是，在浸润性癌中，浸润性小叶癌的检出率明显高于该组织类型的预期。
