Chong Kian-Hwee, Huang Kuo-Feng, Kuo Hsiu-Wen, Tzeng I-Shiang, Chen Jia-Hui
Division of General Surgery, Department of Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan.
Division of Neurosurgery, Department of Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan.
Tzu Chi Med J. 2021 Mar 22;33(3):275-281. doi: 10.4103/tcmj.tcmj_191_20. eCollection 2021 Jul-Sep.
The current study aimed to retrospectively assess the cancer detection rate of needle localization biopsy of breast microcalcifications undetectable on sonography.
Patients who underwent mammography-guided needle localization biopsy of breast microcalcifications undetectable on sonography from January 2005 to December 2017 were included in the study. Patients with incomplete medical records were excluded from the study. Patient mammograms were categorized using the Breast Imaging-Reporting and Data System (BI-RADS) assessment criteria. The percentages of benign and malignant lesions were determined by pathological examination of surgically recovered specimens. Correlation between preoperative imaging assessment and final diagnosis was investigated, and the complications associated with the procedures were recorded.
A total of 301 needle-localized biopsies were performed under mammographic guidance. The mean age of the patients was 58.18 ± 7.73 years. The overall ductal carcinoma (DCIS) and cancer detection rate was 23.3%. The proportion of patients with BI-RADS 0 category and undergoing second mammography was higher in the DCIS and cancer group. A total of 227 patients did not undergo second mammography. Of these patients, 70 demonstrated BI-RADS 4 category, 34 were diagnosed with DCIS, and 5 were diagnosed with breast cancer during subsequent follow-up.
Needle-localized excision of microcalcifications undetectable on sonography has high detection rate for early stage of breast cancer with low risk of associated complications. Regular mammography is a satisfactory follow-up tool for female patients with microcalcifications in the breasts. Additional studies should be performed to compare between needle-localized excision and vacuum-assisted breast biopsy.
本研究旨在回顾性评估超声检查不可见的乳腺微钙化灶针定位活检的癌症检出率。
纳入2005年1月至2017年12月期间接受乳腺钼靶引导下针定位活检的超声检查不可见的乳腺微钙化灶患者。病历不完整的患者被排除在研究之外。使用乳腺影像报告和数据系统(BI-RADS)评估标准对患者的乳腺钼靶片进行分类。通过对手术切除标本的病理检查确定良性和恶性病变的百分比。研究术前影像评估与最终诊断之间的相关性,并记录与手术相关的并发症。
在乳腺钼靶引导下共进行了301次针定位活检。患者的平均年龄为58.18±7.73岁。导管原位癌(DCIS)和癌症的总体检出率为23.3%。DCIS和癌症组中BI-RADS 0类且接受二次乳腺钼靶检查的患者比例较高。共有227例患者未接受二次乳腺钼靶检查。在这些患者中,70例表现为BI-RADS 4类,34例在后续随访中被诊断为DCIS,5例被诊断为乳腺癌。
超声检查不可见的微钙化灶针定位切除对早期乳腺癌具有较高的检出率,且相关并发症风险较低。定期乳腺钼靶检查是乳腺微钙化女性患者令人满意的随访工具。应进行更多研究以比较针定位切除与真空辅助乳腺活检。