术前乳腺磁共振成像对同侧和对侧同步及异时性乳腺癌检出的影响-一项平均随访 102 个月的 1468 例原发性可手术乳腺癌患者的病例对照比较研究。
Impact of pre-operative breast magnetic resonance imaging on contralateral synchronous and metachronous breast cancer detection-A case control comparison study with 1468 primary operable breast cancer patients with mean follow-up of 102 months.
机构信息
Department of Medical Imaging, Changhua Christian Hospital, Changhua, Taiwan.
Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, Taipei, Taiwan.
出版信息
PLoS One. 2021 Nov 18;16(11):e0260093. doi: 10.1371/journal.pone.0260093. eCollection 2021.
BACKGROUND
Women with unilateral breast cancer are at an increased risk for the development of contralateral breast cancers. We hypothesis that combined breast MRI would detect more contralateral synchronous breast cancer than conventional imaging alone, and resulted in less contralateral metachronous breast cancer during follow-up.
METHODS
We retrospectively collected two groups of breast cancer patients diagnosed from 2009 to 2013 for evaluating the effectiveness and value of adding pre-operative breast MRI to conventional breast images (mammography and sonography) for detection of contralateral synchronous breast cancer. The new metachronous contralateral breast cancer diagnosed during follow-up was prospectively evaluated and compared.
RESULTS
Group A (n = 733) comprised patients who underwent conventional preoperative imaging and group B (n = 735) combined with MRI were enrolled and compared. Seventy (9.5%) of the group B patients were found to have contralateral lesions detected by breast MRI, and 65.7% of these lesions only visible with MRI. The positive predictive value of breast MRI detected contralateral lesions was 48.8%. With the addition of breast MRI to conventional imaging studies, more surgical excisions were performed in contralateral breasts (6% (44/735) versus 1.4% (10/733), P< 0.01), more synchronous contralateral breast cancer detected (2.9% (21/735) versus 1.1% (8/733), P = 0.02), and resulted in numerical less (2.2% (16/714) versus 3% (22/725), p = 0.3) metachronous contralateral breast cancer during a mean follow-up of 102 months.
CONCLUSIONS
Our study provides useful estimates of the pre-operative breast MRI for the increased detection of contralateral synchronous breast cancer and less subsequent contralateral metachronous breast cancer.
背景
单侧乳腺癌女性发生对侧乳腺癌的风险增加。我们假设联合乳腺 MRI 比常规成像单独检测到更多的对侧同步乳腺癌，并在随访期间导致更少的对侧异时性乳腺癌。
方法
我们回顾性地收集了两组 2009 年至 2013 年诊断的乳腺癌患者，以评估术前乳腺 MRI 对常规乳腺图像（乳房 X 线摄影和超声）检测对侧同步乳腺癌的有效性和价值。前瞻性评估并比较随访期间新诊断的对侧异时性乳腺癌。
结果
A 组（n = 733）包括接受常规术前成像的患者，B 组（n = 735）联合 MRI 进行检查，比较两组。B 组 70 例（9.5%）患者经乳腺 MRI 发现对侧病变，其中 65.7%仅在 MRI 上可见。乳腺 MRI 检测对侧病变的阳性预测值为 48.8%。与常规成像研究联合应用乳腺 MRI 可增加对侧乳房的手术切除率（6%（44/735）比 1.4%（10/733），P<0.01），检测到更多的对侧同步乳腺癌（2.9%（21/735）比 1.1%（8/733），P = 0.02），且平均随访 102 个月后，对侧异时性乳腺癌的发生率略低（2.2%（16/714）比 3%（22/725），p = 0.3）。
结论
我们的研究为术前乳腺 MRI 检测对侧同步乳腺癌和减少随后的对侧异时性乳腺癌提供了有用的估计。
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