Cheung Yun-Chung, Kuo Wen-Lin, Lee Li-Yu, Tang Ya-Chun
Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Medical College of Chang Gung University, Taoyuan, Taiwan.
Division of Breast Surgery, Department of Surgery, Chang Gung Memorial Hospital, Medical College of Chang Gung University, Taoyuan, Taiwan.
Front Oncol. 2022 Jul 22;12:884576. doi: 10.3389/fonc.2022.884576. eCollection 2022.
Breast cancer in silicone-injected breasts is often obscured in conventional mammography and sonography. Contrast-enhanced magnetic resonance imaging (CE-MRI) is an optimal modality for cancer detection. This case report demonstrates the use of contrast-enhanced spectral mammography (CESM) and CESM-guided biopsy (CESM-Bx) to diagnose breast cancer in silicone-injected breasts. However, there is no relevant report in the literature.
A 59-year-old woman who received a liquid silicone injection for breast augmentation 30 years ago was transferred to our hospital for a CE-MRI-guided biopsy due to a suspicion of cancer in her right breast. The CE-MRI showed a 3.1-cm irregular enhanced mass and a 1.1-cm circumscribe mass in the upper outer quadrant of the right breast. Unfortunately, the CE-MRI-guided biopsy had to wait for 1 month due to a busy schedule. The CESM revealed two masses that were consistent with CE-MRI findings. CESM-Bx was performed, and the patient was diagnosed with invasive lobular carcinoma with an irregular mass and fibroadenoma of the circumscribed mass. The patient underwent substantial surgery.
CESM-Bx is a simple emerging technique that can be used feasibly to obtain tissue proof on the concerned enhanced lesion on CESM. In such cases of silicone-injected breasts, the CESM-Bx can be used as an alternative to MRI-guided biopsy for cancer diagnosis.
在传统乳腺X线摄影和超声检查中，注射过硅酮的乳房中的乳腺癌常难以显示。对比增强磁共振成像（CE-MRI）是检测癌症的最佳方式。本病例报告展示了使用对比增强光谱乳腺摄影（CESM）及CESM引导下活检（CESM-Bx）来诊断注射过硅酮的乳房中的乳腺癌。然而，文献中尚无相关报告。
一名59岁女性，30年前接受了液态硅酮注射隆乳，因怀疑右乳癌症被转至我院接受CE-MRI引导下活检。CE-MRI显示右乳外上象限有一个3.1厘米的不规则强化肿块和一个1.1厘米的边界清晰的肿块。不幸的是，由于日程繁忙，CE-MRI引导下活检不得不推迟1个月。CESM显示了两个与CE-MRI结果一致的肿块。进行了CESM-Bx，患者被诊断为浸润性小叶癌，不规则肿块为纤维腺瘤，边界清晰的肿块为纤维瘤。患者接受了根治性手术。
CESM-Bx是一种简单的新兴技术，可切实用于获取关于CESM上相关强化病变的组织证据。在注射过硅酮的乳房这类病例中，CESM-Bx可作为MRI引导下活检的替代方法用于癌症诊断。
