超声引导下可疑乳腺病变的芯针活检

K. Lőrincz, Z. Pap, S. Mocan, Csanád-Endre Lőrincz, B. Baróti
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摘要

背景:乳腺癌是女性中死亡率最高的癌症。虽然早期发现是西欧国家公共卫生的优先事项,但我国尚未实施筛查方案。最好的诊断准确性是通过使用三重评估来实现的:临床检查,成像和指征时的核心针活检。预后受临床、组织学和生物学因素的影响,个体化治疗最有效。目的:分析活检结节的临床、组织学和免疫组织化学特征,总结近三年来的经验。材料和方法:我们回顾性分析了2017年至2019年期间接受核心针活检的137例患者的数据。影像学评分基于超声检查或乳房x光检查。记录临床及病理参数,并对数据进行统计学处理。结果:患者平均年龄58±14岁,病灶平均大小22.83±14.10 mm。大多数结节(n = 63, 47.01%)位于上外侧象限,双侧结节4例(3.08%)。我们发现病变大小与患者年龄呈显著正相关(Spearman r = 0.356;95% ci 0.186, 0.506;P = 0.000)。乳腺成像报告和数据系统(BI-RADS)分类中恶性肿瘤发生率为:“4a”为0%,“4b”为31.58%,“4c”为71.42%,“5”为97.72%。大多数恶性肿瘤以无特殊类型的浸润性导管癌为代表(n = 73, 78.35%), 2级58.43% (n = 52),雌激素受体阳性89.13% (n = 82),以腔内b样型最常见(n = 63, 78.75%)。结论:肿瘤的平均大小大于文献中描述的发现时的平均大小。在我们的地区,年龄和肿瘤大小呈正相关。术前组织学结果可提示影像学风险分层系统的可靠性。大多数病例可从辅助内分泌治疗中获益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Ultrasound-Guided Core-Needle Biopsy of Suspicious Breast Lesions
Abstract Background: Breast cancer is the female cancer with the highest mortality. While early detection is a public health priority in Western European countries, a screening program in our country has yet to be implemented. The best diagnostic accuracy is achieved through the use of triple assessment: clinical examination, imaging, and core-needle biopsy where indicated. Prognosis is influenced by clinical, histological, and biological factors, and therapy is most effective when individually tailored. Aim of the study: To analyze the clinical, histological, and immunohistochemical characteristics of the biopsied nodules and summarize our experience from the last three years. Material and Methods: We retrospectively analyzed data from 137 patients who underwent core-needle biopsy between 2017 and 2019. Imaging score was assigned based on ultrasound examination or mammography. Clinical and pathological parameters were recorded, followed by statistical processing of the data. Results: The mean age of the patients was 58 ± 14 years, lesions had a mean size of 22.83 ± 14.10 mm. Most nodules (n = 63, 47.01%) were located in the upper-outer quadrant, and bilateral presence was found in 4 (3.08%) cases. We found a significant positive correlation between lesion size and the patients’ age (Spearman r = 0.356; 95% CI 0.186, 0.506; p = 0.000). The malignancy rates within the Breast Imaging Reporting and Data System (BI-RADS) categories were as follows: 0% for „4a”, 31.58% for „4b”, 71.42% for „4c”, and 97.72% for „5”. Most malignancies (n = 73, 78.35%) were represented by invasive ductal carcinoma of no special type, 58.43% (n = 52) were grade 2, 89.13% (n = 82) were estrogen receptor positive, and Luminal B-like type was the most common (n = 63, 78.75%). Conclusions: The mean size of tumors was larger than the average size at discovery described in the literature. In our region, age and tumor size are positively correlated. Preoperative histological results may indicate the reliability of the imaging risk stratification system. Most cases can benefit from adjuvant endocrine therapy.
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