Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil.
Divisão de Ginecologia, Setor de Mastologia, Instituto do Câncer do Estado de São Paulo, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
Rev Bras Ginecol Obstet. 2022 Jan;44(1):67-73. doi: 10.1055/s-0041-1741409. Epub 2022 Jan 29.
To evaluate the underestimation rate in breast surgical biopsy after the diagnosis of radial scar/complex sclerosing lesion through percutaneous biopsy.
A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. The PubM: ed, SciELO, Cochrane, and Embase databases were consulted, with searches conducted through November 2020, using specific keywords ( OR: , , AND/OR: ).
Study selection was conducted by two researchers experienced in preparing systematic reviews. The eight selected articles were fully read, and a comparative analysis was performed.
A total of 584 studies was extracted, 8 of which were selected. One of them included women who had undergone a percutaneous biopsy with a histological diagnosis of radial scar/complex sclerosing lesion and subsequently underwent surgical excision; the results were used to assess the underestimation rate of atypical and malignant lesions.
The overall underestimation rate in the 8 studies ranged from 1.3 to 40% and the invasive lesion underestimation rate varied from 0 to 10.5%.
The histopathological diagnosis of a radial scar/complex sclerosing lesion on the breast is not definitive, and it may underestimate atypical and malignant lesions, which require a different treatment, making surgical excision an important step in diagnostic evaluation.
评估经皮活检诊断为放射状瘢痕/复杂硬化性病变后乳腺外科活检的低估率。
按照系统评价和荟萃分析的首选报告项目(PRISMA)建议进行系统评价。检索了 PubM: ed、SciELO、Cochrane 和 Embase 数据库,检索时间截至 2020 年 11 月,使用特定关键词(OR:,,AND/OR:)。
两名有系统评价准备经验的研究人员进行了研究选择。对 8 篇选定的文章进行了全面阅读,并进行了对比分析。
共提取了 584 项研究,其中 8 项被选中。其中一项研究纳入了经皮活检组织学诊断为放射状瘢痕/复杂硬化性病变且随后行外科切除的女性;结果用于评估不典型和恶性病变的低估率。
8 项研究的总体低估率范围为 1.3%至 40%,侵袭性病变的低估率范围为 0%至 10.5%。
乳腺放射状瘢痕/复杂硬化性病变的组织病理学诊断并不确定,可能会低估不典型和恶性病变,这些病变需要不同的治疗,因此外科切除是诊断评估的重要步骤。