Jha Anamika, Chaudhary Ranjit Kumar, Shrivastav Shreya, Khanal Umesh
Department of Radiodiagnosis and Imaging, Tribhuvan University Institute of Medicine, Maharajgunj, Kathmandu, Nepal.
Department of Radiology, St Vincent's Medical Center, Bridgeport, CT, United States of America.
PLoS One. 2024 Dec 5;19(12):e0301180. doi: 10.1371/journal.pone.0301180. eCollection 2024.
Retroareolar region refers to the region within two centimeters from the nipple and/or involves the nipple-areolar complex on mammogram. In this study, we graded asymmetric retroareolar density on mammography and determined the underlying cause.
To identify and grade retroareolar densities and evaluate characteristics of lesion using ultrasonography and histopathology.
Mammograms with asymmetric retroareolar density done in our tertiary care hospital were included. Retroareolar density was categorized into three grades based on morphological appearance in mammography. Sonography was performed in all patients and tissue diagnosis was obtained for suspicious lesions.
Of the 100 patients included in the study, most of the patients with mammographic grade 1, grade 2 and 3 retroareolar asymmetry had normal sonography, pathologically proven mastitis and invasive ductal carcinoma, respectively. Presenting indication usually was diagnostic (n = 87), lump being most common. Benign (58%) diagnosis was more often present, with equal number of normal studies and malignancies (21%). Frequently pathologically proven malignant lesions (n = 17) had grade 3 asymmetry and none were grade 1. Invasive ductal carcinoma was the most common malignancy while mastitis the most common benign disease.
Grade I retroareolar asymmetric density on mammography was normal or had a benign etiology while grade 2 or 3 asymmetric density had underlying pathology, often malignancy.
Grading retroareolar density in mammogram may improve the evaluation of retroareolar region and increase emphasis on higher grades.
乳晕后区域是指距离乳头两厘米以内的区域，和/或在乳腺钼靶片上累及乳头乳晕复合体。在本研究中，我们对乳腺钼靶片上乳晕后密度不对称进行分级，并确定其潜在病因。
识别并分级乳晕后密度，利用超声和组织病理学评估病变特征。
纳入在我们三级医疗机构进行的乳腺钼靶片上有乳晕后密度不对称的病例。根据乳腺钼靶片上的形态外观，将乳晕后密度分为三个等级。对所有患者进行超声检查，并对可疑病变进行组织诊断。
在纳入研究的100例患者中，乳腺钼靶片上乳晕后不对称分级为1级、2级和3级的患者，超声检查结果大多分别为正常、病理证实为乳腺炎和浸润性导管癌。就诊指征通常是诊断性的（n = 87），肿块最为常见。良性诊断（58%）更为常见，正常检查和恶性肿瘤的数量相等（21%）。经病理证实的恶性病变（n = 17）通常为3级不对称，无1级病变。浸润性导管癌是最常见的恶性肿瘤，而乳腺炎是最常见的良性疾病。结论：乳腺钼靶片上1级乳晕后不对称密度为正常或病因良性，而2级或3级不对称密度有潜在病理改变，常为恶性。
对乳腺钼靶片上乳晕后密度进行分级可改善对乳晕后区域的评估，并增加对高级别病变的重视。
