Guangdong Provincial Key Laboratory of Malignant Tumour Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China.
Breast Tumor Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China.
BMC Womens Health. 2024 Feb 3;24(1):87. doi: 10.1186/s12905-024-02910-w.
Approximately 50% of breast mucinous carcinomas (MCs) are oval and have the possibility of being misdiagnosed as fibroadenomas (FAs). We aimed to identify the key features that can help differentiate breast MC with an oval shape from FA on ultrasonography (US).
Seventy-six MCs from 71 consecutive patients and 50 FAs with an oval shape from 50 consecutive patients were included in our study. All lesions pathologically diagnosed. According to the Breast Imaging Reporting and Data System (BI-RADS), first, the ultrasonographic features of the MCs and FAs were recorded and a final category was assessed. Then, the differences in ultrasonographic characteristics between category 4 A (low-risk group) and category 4B-5 (medium-high- risk group) MCs were identified. Finally, other ultrasonographic features of MC and FA both with an oval shape were compared to determine the key factors for differential diagnosis. The Mann-Whitney test, χ test or Fisher's exact test was used to compare data between groups.
MCs with an oval shape (81.2%) and a circumscribed margin (25%) on US were more commonly assessed in the low-risk group (BI-RADS 4 A) than in the medium-high-risk group (BI-RADS 4B-5) (20%, p < 0.001 and 0%, p = 0.001, respectively). Compared with those with FA, patients with MC were older, and tended to have masses with non-hypoechoic patterns, not circumscribed margins, and a posterior echo enhancement on US (p < 0.001, p < 0.001, and p = 0.003, respectively).
The oval shape was the main reason for the underestimation of MCs. On US, an oval mass found in the breast of women of older age with non-hypoechoic patterns, not circumscribed margins, and a posterior echo enhancement was associated with an increased risk of being an MC, and should be subjected to active biopsy.
约 50%的乳腺黏液癌（MC）呈椭圆形，有可能被误诊为纤维腺瘤（FA）。我们旨在确定有助于区分超声表现为椭圆形的乳腺 MC 与 FA 的关键特征。
纳入了 71 例连续患者的 76 例 MC 和 50 例连续患者的 50 例 FA（椭圆形），所有病变均经病理诊断。根据乳腺影像报告和数据系统（BI-RADS），首先记录 MC 和 FA 的超声特征并评估最终类别，然后确定 BI-RADS 4A（低危组）和 BI-RADS 4B-5（中高危组）MC 之间超声特征的差异，最后比较 MC 和 FA（椭圆形）的其他超声特征，以确定鉴别诊断的关键因素。组间数据比较采用 Mann-Whitney 检验、χ检验或 Fisher 确切概率法。
超声表现为椭圆形（81.2%）和边界清楚（25%）的 MC 更常被评估为低危组（BI-RADS 4A），而非中高危组（BI-RADS 4B-5）（20%，p<0.001 和 0%，p=0.001）。与 FA 相比，MC 患者年龄更大，肿块在超声上常表现为非低回声、边界不清楚、后方回声增强（p<0.001、p<0.001 和 p=0.003）。
椭圆形是低估 MC 的主要原因。在超声上，对于年龄较大的女性乳房中发现的椭圆形肿块，若其超声表现为非低回声、边界不清楚、后方回声增强，提示 MC 的风险增加，应进行积极的活检。
