Department of Radiological and Medical Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Radiological Technology, Hokkaido University of Science, Sapporo, Japan.
Int J Comput Assist Radiol Surg. 2021 Nov;16(11):1915-1923. doi: 10.1007/s11548-021-02472-4. Epub 2021 Aug 13.
Our previous study suggests that the cross-sectional morphology of ducts and branching of ducts in the nipple are associated with the presence of breast cancer. In this study, we evaluated whether cross-sectional morphology and duct branching of human nipple obtained by X-ray dark-field imaging tomographic technique (XDFI-CT) could predict the likelihood of the presence of intraductal cancer into the nipple.
A total of 51 nipple specimens were obtained from consecutive total mastectomies performed for breast cancer in Nagoya Medical Center. After reconstructing 3D images of the nipple using XDFI-CT, the cross-sectional images and the 3D arrangement of ducts were extracted. These cross-sectional images of ducts were classified into four patterns based on the status of the lumen without being informed of pathology results.
Of the four patterns, the distended ducts with heterogenous content were highly correlated with the presence of ductal carcinoma in situ confirmed by histopathology. The total number of orifices identified in the 51 specimens was 1298, and 182 (14%) at the tip and 19 (1.5%) at least 5 mm depth from the tip were composed of two or more ducts.
Anatomy of nipple ducts is essential to evaluate risk of local recurrence after nipple-sparing mastectomy because cancerous spread occurs within the duct of the same segment of the mammary duct-lobular system in the in situ stage. The 3D microscale anatomy of nipple ducts revealed by XDFI-CT provides useful information to assess the risk of breast cancer involvement at the preserved portion in nipple-sparing mastectomy.
我们之前的研究表明，乳头内导管的横断形态和分支与乳腺癌的存在有关。在这项研究中，我们评估了通过 X 射线暗场成像层析技术（XDFI-CT）获得的乳头的横断形态和导管分支是否可以预测乳头内癌的存在可能性。
从名古屋医疗中心因乳腺癌行全乳房切除术的连续病例中获得了 51 个乳头标本。使用 XDFI-CT 重建乳头的 3D 图像后，提取了导管的横截面图像和 3D 排列。这些导管的横截面图像根据管腔的状态分为四种模式，而不告知病理结果。
在四种模式中，扩张的导管伴不均匀内容物与组织病理学证实的导管原位癌的存在高度相关。在 51 个标本中，总共鉴定出 1298 个孔，在尖端 182 个（14%）和尖端至少 5 毫米深处的 19 个（1.5%）由两个或更多导管组成。
乳头导管的解剖结构对于评估保乳乳房切除术局部复发的风险至关重要，因为原位阶段的癌性扩散发生在同一乳腺导管-小叶系统段的导管内。XDFI-CT 显示的乳头导管的 3D 微观解剖结构提供了有用的信息，可用于评估保乳乳房切除术保留部分乳腺癌受累的风险。
