Laboratory of Department of Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Guangdong, China.
Department of Thyroid and Breast Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Guangdong, China.
BMC Cancer. 2021 May 29;21(1):633. doi: 10.1186/s12885-021-08382-7.
The purpose of this study was to determine the validity of the ultrasound features as well as patient characteristics assigned to B3 (uncertain malignant potential) breast lesions before vacuum-assisted excision biopsy (VAEB).
This study population consisted of 2245 women with breast-nodular abnormalities, which were conducted ultrasound-guided VAEB (US-VAEB). Patient's clinical and anamnestic data and lesion-related ultrasonic feature variables of B3 captured before US-VAEB were compared with those of benign or malignant cases, using histopathological results as a benchmark.
The proportions of benign, B3 and malignant breast lesions diagnosed post-US-VAEB were 88.5, 8.2 and 3.4% respectively. B3 high frequent occurred in BI-RADS-US grade 3 (7.7%), grade 4a (11.0%) and grade 4b (9.1%). The overall malignancy underestimation rate of B3 was 4.4% (8/183). Malignant lesions were found mostly in the range of BI-RADS grade 4b (27.3%), grade 4c (33.3%) and grade 5 (100%). Multivariate binary logistic regression analyses (B3 vs benign) showed that non-menopausal patients (95% CI 1.628-8.616, P = 0.002), single (95% CI 1.370-2.650, P = 0.000) or vascularity (95% CI 1.745-4.150, P = 0.000) nodules in ultrasonic features were significant risk factors for B3 occurrences. In addition, patients elder than 50 years (95% CI 3.178-19.816, P = 0.000), unclear margin (95% CI 3.571-14.119, P = 0.000) or suspicious calcification (95% CI 4.010-30.733, P = 0.000) lesions were significantly associated with higher risks of malignant potentials for B3 cases (malignant vs B3).
The results of this study indicate that ultrasound findings and patients' characteristics might provide valuable information for distinguishing B3 lesions from benign breast abnormalities before VAEB, and help to reduce malignancy underestimation of B3.
本研究旨在确定在真空辅助切除活检（VAEB）前，超声特征以及分配给 B3（不确定的恶性潜能）病变的患者特征的有效性。
本研究人群由 2245 名患有乳腺结节异常的女性组成，这些女性均进行了超声引导的 VAEB（US-VAEB）。将 B3 之前的患者临床和病史数据以及与病变相关的超声特征变量与良性或恶性病例进行比较，并以组织病理学结果为基准。
US-VAEB 后诊断为良性、B3 和恶性乳腺病变的比例分别为 88.5%、8.2%和 3.4%。B3 高频率出现在 BI-RADS-US 3 级（7.7%）、4a 级（11.0%）和 4b 级（9.1%）。B3 的总体恶性低估率为 4.4%（8/183）。恶性病变主要出现在 BI-RADS 4b 级（27.3%）、4c 级（33.3%）和 5 级（100%）。多变量二元逻辑回归分析（B3 与良性）表明，非绝经患者（95%CI 1.628-8.616，P=0.002）、单发（95%CI 1.370-2.650，P=0.000）或血管性（95%CI 1.745-4.150，P=0.000）结节的超声特征是 B3 发生的显著危险因素。此外，年龄大于 50 岁的患者（95%CI 3.178-19.816，P=0.000）、边界不清（95%CI 3.571-14.119，P=0.000）或可疑钙化（95%CI 4.010-30.733，P=0.000）的病变与 B3 恶性潜能升高显著相关。
本研究结果表明，超声表现和患者特征可能为 VAEB 前区分 B3 病变与良性乳腺异常提供有价值的信息，并有助于减少 B3 的恶性低估。
