Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 9 Dongdansantiao, Beijing, 100730, China.
BMC Med Imaging. 2023 Jan 6;23(1):3. doi: 10.1186/s12880-022-00934-y.
Intraductal papillary carcinoma (IDPC) is a rare but fatal disease. Preoperative ultrasound diagnosis of IDPC remains challenging and meaningful. The aim of the study was to determine an effective ultrasound model to predict intraductal papillary carcinoma (IDPC) in patients with partially cystic breast lesions on ultrasound.
We reviewed female patients with breast nodules who underwent biopsy or surgery between 2004 and 2019, and pathological results were used as the reference standard. We finally included 21 IDPC patients with partially cystic lesions on preoperative ultrasound matched to 40 patients with intraductal papilloma. The association of ultrasound features with IDPC was analysed.
Posterior echo enhancement (P < 0.001), tumour size (P = 0.002), irregular shape (P = 0.003), wide base (P = 0.003), solid-mainly component (P = 0.013), rich Doppler flow (P < 0.001) and multiple lesions (P = 0.044) were associated with IDPC by univariate analysis. Based on univariate analysis, variables were included in the regression analysis to obtain independent factors. The regression analysis showed that microcalcification, multiple lesions, posterior echo enhancement, wide base of solid components and rich colour Doppler flow were predictors for IDPC (P < 0.001). The collective model of the independent factors (microcalcification, multiple lesions, posterior echo enhancement, wide base of solid components and rich colour Doppler flow) could predict IDPC with an area under the curve (AUC) of 0.99 (95% CI 0.95-1.00). The collective model had a better net benefit demonstrated by the decision curve.
Ultrasonic features may be an applicable model for predicting IDPC with partially cystic breast lesions on ultrasound and has a better potential to facilitate decision-making preoperatively.
导管内乳头状癌（IDPC）是一种罕见但致命的疾病。术前超声诊断 IDPC 仍然具有挑战性和意义。本研究旨在确定一种有效的超声模型，以预测超声显示部分囊性乳腺病变患者的导管内乳头状癌（IDPC）。
我们回顾了 2004 年至 2019 年间接受活检或手术的女性乳腺结节患者，以病理结果为参考标准。最终纳入 21 例术前超声显示部分囊性病变的 IDPC 患者，与 40 例导管内乳头状瘤患者相匹配。分析超声特征与 IDPC 的相关性。
通过单因素分析，后向回声增强（P<0.001）、肿瘤大小（P=0.002）、不规则形状（P=0.003）、宽基底（P=0.003）、实性为主成分（P=0.013）、丰富的多普勒血流（P<0.001）和多发病灶（P=0.044）与 IDPC 相关。基于单因素分析，将变量纳入回归分析以获得独立因素。回归分析显示，微钙化、多发病灶、后向回声增强、实性成分宽基底和丰富的彩色多普勒血流是 IDPC 的预测因素（P<0.001）。独立因素的综合模型（微钙化、多发病灶、后向回声增强、实性成分宽基底和丰富的彩色多普勒血流）可预测 IDPC，曲线下面积（AUC）为 0.99（95%CI 0.95-1.00）。决策曲线显示，综合模型具有更好的净收益。
超声特征可能是一种适用于预测超声显示部分囊性乳腺病变患者 IDPC 的模型，具有更好的术前决策潜力。
