核心针活检中发现的乳腺放射状瘢痕/复杂硬化性病变的上移率。
Upstage rate of radial scar/complex sclerosing lesion identified on core needle biopsy.
机构信息
Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON, N6A 5A5, Canada; Providence Breast Centre, Mount Saint Joseph Hospital, 3080 Prince Edward Street, Vancouver, BC, V5T 3N4, Canada.
Providence Breast Centre, Mount Saint Joseph Hospital, 3080 Prince Edward Street, Vancouver, BC, V5T 3N4, Canada.
出版信息
Am J Surg. 2021 Jun;221(6):1177-1181. doi: 10.1016/j.amjsurg.2021.03.029. Epub 2021 Mar 18.
BACKGROUND
We assessed the cancer upstage rate of Radial Scars (RS), and Complex Sclerosing Lesions (CSL), and risk-stratified lesions based on radiological and pathological features.
METHODS
Characteristics of RS/CSL treated from 2013 to 2018 were examined for features associated with cancer.
RESULTS
78 RS/CSL were found on core needle biopsy (CNB) and surgically excised. 9 (11.5%) lesions were upstaged. Upstaged patients were older (66 vs 51, p = 0.033). More upstaged lesions were accompanied by a mass on both mammography (87.5% vs. 30.0%, p = 0.005) and ultrasound (100.0% vs. 62.8%, p = 0.043). 20.5% of lesions biopsied under ultrasound guidance with small needles (14-18G) were upstaged, but no lesions biopsied under stereotactic guidance with large needles (9-12 G) with vacuum assistance were upstaged (p = 0.009).
CONCLUSIONS
Excision of RS/CSL seen on CNB is warranted, especially if the patient is older, the CNB is performed under ultrasound guidance with small needles, or if a mass is present on imaging.
背景
我们评估了基于影像学和病理学特征的放射状瘢痕（RS）和复杂硬化病变（CSL）以及风险分层病变的癌症升级率。
方法
对 2013 年至 2018 年接受 RS/CSL 治疗的患者的特征进行了检查，以确定与癌症相关的特征。
结果
在核心针活检（CNB）和手术切除中发现了 78 个 RS/CSL。9 个（11.5%）病变升级。升级的患者年龄更大（66 岁比 51 岁，p=0.033）。更多升级的病变在乳房 X 线照相术（87.5%比 30.0%，p=0.005）和超声（100.0%比 62.8%，p=0.043）上都伴有肿块。在超声引导下用小针（14-18G）活检的病变中有 20.5%升级，但在立体定向引导下用大针（9-12G）并带有真空辅助的病变中没有升级（p=0.009）。
结论
如果患者年龄较大、CNB 在超声引导下用小针进行、或影像学上存在肿块，则需要对 CNB 上见到的 RS/CSL 进行切除。
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