Rehman Sara, Niazi Imran Khalid, Naveed Muhammad Atif, Javaid Ainy, Rehman Bushra
Department of Radiology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan.
Department of Breast Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan.
Eur J Breast Health. 2020 Dec 24;17(1):28-35. doi: 10.4274/ejbh.2020.5858. eCollection 2021 Jan.
This study aimed to evaluate the diagnostic accuracy of breast ultrasonography in classifying incidental satellite masses as benign or malignant in patients with breast cancer and to assess its effect on their surgical management.
Ultrasound-guided fine needle aspiration/biopsy was performed in 288 satellite masses of 225 patients with breast cancer. Two radiologists retrospectively reviewed the sonograms of these masses and classified them as benign or malignant and compared this feature with the results of the histopathological examination. The location of the satellite mass and type of surgery were also documented.
Of the 288 satellite masses, 139 were located in the same quadrant, 95 in different quadrants, while 54 were in the contralateral breast. Of the 123 sonographically benign masses, 106 showed benign pathological outcome, and from 165 sonographically malignant masses, 127 were found malignant on histopathology/cytology. McNemar's chi-square was 7.27 (p-value=0.007), showing statistically significant association between sonographic features and pathological outcome of satellite masses. The sensitivity, specificity, positive and negative predictive values, and accuracy were 88.2%, 73.6%, 77%, 86.1%, and 80.9% respectively. Based on these findings, 61 patients underwent lumpectomy limited to a single tumor, 52 underwent extended resection, 78 underwent mastectomy, four underwent lumpectomy for the contralateral breast, and bilateral mastectomies were performed in another four patients. Surgery was not performed in 26 patients.
Although ultrasound is an effective tool for the detection and characterization of incidental satellite masses in patients with breast cancer, biopsy is imperative to ascertain the pathological diagnosis and, therefore, select the most appropriate surgical plan.
本研究旨在评估乳腺超声在将乳腺癌患者的偶然卫星灶肿块分类为良性或恶性方面的诊断准确性，并评估其对手术治疗的影响。
对225例乳腺癌患者的288个卫星灶进行超声引导下细针穿刺抽吸/活检。两名放射科医生回顾性分析这些肿块的超声图像，将其分类为良性或恶性，并将此特征与组织病理学检查结果进行比较。还记录了卫星灶的位置和手术类型。
288个卫星灶中，139个位于同一象限，95个位于不同象限，54个位于对侧乳房。123个超声检查为良性的肿块中，106个病理结果为良性；165个超声检查为恶性的肿块中，127个在组织病理学/细胞学检查中为恶性。McNemar卡方检验值为7.27（p值=0.007），表明卫星灶的超声特征与病理结果之间存在统计学显著关联。敏感性、特异性、阳性预测值、阴性预测值和准确性分别为88.2%、73.6%、77%、86.1%和80.9%。基于这些结果，61例患者接受了仅针对单个肿瘤的肿块切除术，52例接受了扩大切除术，78例接受了乳房切除术，4例接受了对侧乳房肿块切除术，另有4例患者接受了双侧乳房切除术。26例患者未进行手术。
尽管超声是检测和鉴别乳腺癌患者偶然卫星灶肿块的有效工具，但活检对于确定病理诊断并因此选择最合适的手术方案至关重要。
