Carlotti G A, Siragusa A, Grillo Ruggieri F, Vitali M L, Grimaldi A, Barone D
Servizio di Radiodiagnostica, Ospedali Galliera, Genova.
Radiol Med. 1993 Jul-Aug;86(1-2):101-5.
The mammographic patterns of the patients treated with conservative surgery (quadrantectomy) plus radiotherapy for early breast carcinoma were evaluated to assess treatment-induced changes over time and to improve the differential diagnosis between postirradiation effects and possible tumor recurrences. The mammographic examinations of 79 patients who had undergone quadrantectomy and radiotherapy for breast carcinoma (stage T1-T2) were examined. Skin thickening, edema, fibrosis, distortion and calcifications were considered and classified by comparing the radiographic patterns of the treated breast with those of the contralateral and untreated one. Pattern changes over time were also evaluated and quantified by comparing serial follow-up examinations of the same breast. The percentage of patients with irradiation-induced skin thickening steadily reduced from 100% at 6 months to just above 50% at 4 years. The number of patients showing diffuse irradiation-induced edema decreased from 56% at 6 months to 15% at 1 year and to 0% at 2 years, while the number of cases with localized edema decreased more slowly. The incidence of localized postirradiation breast fibrosis increased to 74% at 4 years, while diffuse fibrosis stabilized around 14%. The patients with no postoperative breast distortion accounted for nearly 33% of the examined cases, while those with minimal distortion approximated 58% and those with gross distortion 9%. In conclusion, the overall results confirmed the value of mammography in the follow-up of the patients treated with QUART.
对早期乳腺癌采用保乳手术（象限切除术）加放疗治疗的患者的乳腺钼靶影像模式进行评估，以评估随时间推移治疗引起的变化，并改善放疗后效应与可能的肿瘤复发之间的鉴别诊断。对79例接受了乳腺癌（T1 - T2期）象限切除术和放疗的患者的乳腺钼靶检查进行了分析。通过将患侧乳腺的影像模式与对侧未治疗乳腺的影像模式进行比较，对皮肤增厚、水肿、纤维化、变形和钙化进行了观察和分类。还通过比较同一乳腺的系列随访检查，对随时间的影像模式变化进行了评估和量化。放疗引起皮肤增厚的患者比例从6个月时的100%稳步下降至4年时略高于50%。出现弥漫性放疗引起水肿的患者数量从6个月时的56%降至1年时的15%，并在2年时降至0%，而局限性水肿的病例数量下降较慢。放疗后局部乳腺纤维化的发生率在4年时升至74%，而弥漫性纤维化稳定在14%左右。术后无乳腺变形的患者占检查病例的近33%，轻度变形的患者约占58%，重度变形的患者占9%。总之，总体结果证实了乳腺钼靶在接受象限切除术、腋窝淋巴结清扫术、放疗（QUART）治疗患者随访中的价值。
