{"title":"磁共振成像在乳腺癌筛查中显示出优越性的病例介绍","authors":"M. Jaffer, Kibe John Ng’ang’a","doi":"10.36502/2023/asjbccr.6333","DOIUrl":null,"url":null,"abstract":"Background: Common modalities for breast cancer screening include regular clinical breast exams (73%), annual breast sonograms (73%) for high-risk groups, and mammograms (71.5%) recommended every 3 years for high-risk groups. Despite a higher sensitivity of 89.4%, MRI is underutilized, especially among high-risk groups with the means for the test. Kenyan guidelines recommend mammography for normal-risk populations, omitting MRI for routine screening in average-risk populations. This study explores an intriguing case of a 60-year-old post-menopausal lady, with no hormone replacement history, three parities, and a smoking habit. She presented with a left-sided benign cyst but revealed an ominous, undetected lesion on the right breast, emphasizing the limitations of conventional screening modalities.\nMethod: The patient was admitted for abdominal pain due to gastroenteritis and a breast lump on the left breast for 3 months with a strong family history of breast cancer, so she requested screening for the same. In the process, we found axillary and mediastinal lymph nodes, but the left breast showed a simple harmless cystic lesion. The right breast confirmed a lesion with irregular borders that looked suspicious, and a biopsy confirmed ductal carcinoma of the right breast.\nResults: The right breast that had no symptoms or signs, and no abnormality on mammogram, ultrasound, or CT scan, had a grade 3a Ductal Cancer in its initial stage that was seen on a simultaneous MRI. Conclusion: MRI could be a better choice for screening early breast cancer in high-risk groups and in those who can afford the test.","PeriodicalId":93523,"journal":{"name":"Asploro journal of biomedical and clinical case reports","volume":"36 2","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Case Presentation where MRI shows Superiority as A Modality for Breast Cancer Screening\",\"authors\":\"M. Jaffer, Kibe John Ng’ang’a\",\"doi\":\"10.36502/2023/asjbccr.6333\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: Common modalities for breast cancer screening include regular clinical breast exams (73%), annual breast sonograms (73%) for high-risk groups, and mammograms (71.5%) recommended every 3 years for high-risk groups. Despite a higher sensitivity of 89.4%, MRI is underutilized, especially among high-risk groups with the means for the test. Kenyan guidelines recommend mammography for normal-risk populations, omitting MRI for routine screening in average-risk populations. This study explores an intriguing case of a 60-year-old post-menopausal lady, with no hormone replacement history, three parities, and a smoking habit. She presented with a left-sided benign cyst but revealed an ominous, undetected lesion on the right breast, emphasizing the limitations of conventional screening modalities.\\nMethod: The patient was admitted for abdominal pain due to gastroenteritis and a breast lump on the left breast for 3 months with a strong family history of breast cancer, so she requested screening for the same. In the process, we found axillary and mediastinal lymph nodes, but the left breast showed a simple harmless cystic lesion. The right breast confirmed a lesion with irregular borders that looked suspicious, and a biopsy confirmed ductal carcinoma of the right breast.\\nResults: The right breast that had no symptoms or signs, and no abnormality on mammogram, ultrasound, or CT scan, had a grade 3a Ductal Cancer in its initial stage that was seen on a simultaneous MRI. 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引用次数: 0
摘要
背景:乳腺癌筛查的常见方式包括定期临床乳房检查(73%)、每年为高危人群进行乳房超声波检查(73%),以及建议高危人群每 3 年进行一次乳房 X 光检查(71.5%)。尽管核磁共振成像的灵敏度较高,达到 89.4%,但其利用率并不高,尤其是在有能力进行该检查的高危人群中。肯尼亚的指南建议正常风险人群进行乳房 X 线照相术,而忽略了对普通风险人群进行核磁共振成像常规筛查。本研究探讨了一个有趣的病例:一位 60 岁的绝经后妇女,无激素替代史,三次生育,有吸烟习惯。她的左侧乳房有良性囊肿,但右侧乳房却有一个未被发现的不祥病灶,这凸显了传统筛查方法的局限性:该患者因肠胃炎导致腹痛和左侧乳房肿块入院 3 个月,有较强的乳腺癌家族史,因此要求进行乳腺癌筛查。在检查过程中,我们发现了腋窝和纵隔淋巴结,但左侧乳房显示为简单无害的囊性病变。右侧乳房的病变边界不规则,看起来很可疑,活检证实为右侧乳腺导管癌:结果:右侧乳房没有任何症状或体征,乳房 X 光检查、超声波检查或 CT 扫描均未发现异常,但同时进行的核磁共振成像检查却显示其为 3a 级乳腺导管癌。结论核磁共振成像是筛查高危人群和有经济能力者早期乳腺癌的更好选择。
Case Presentation where MRI shows Superiority as A Modality for Breast Cancer Screening
Background: Common modalities for breast cancer screening include regular clinical breast exams (73%), annual breast sonograms (73%) for high-risk groups, and mammograms (71.5%) recommended every 3 years for high-risk groups. Despite a higher sensitivity of 89.4%, MRI is underutilized, especially among high-risk groups with the means for the test. Kenyan guidelines recommend mammography for normal-risk populations, omitting MRI for routine screening in average-risk populations. This study explores an intriguing case of a 60-year-old post-menopausal lady, with no hormone replacement history, three parities, and a smoking habit. She presented with a left-sided benign cyst but revealed an ominous, undetected lesion on the right breast, emphasizing the limitations of conventional screening modalities.
Method: The patient was admitted for abdominal pain due to gastroenteritis and a breast lump on the left breast for 3 months with a strong family history of breast cancer, so she requested screening for the same. In the process, we found axillary and mediastinal lymph nodes, but the left breast showed a simple harmless cystic lesion. The right breast confirmed a lesion with irregular borders that looked suspicious, and a biopsy confirmed ductal carcinoma of the right breast.
Results: The right breast that had no symptoms or signs, and no abnormality on mammogram, ultrasound, or CT scan, had a grade 3a Ductal Cancer in its initial stage that was seen on a simultaneous MRI. Conclusion: MRI could be a better choice for screening early breast cancer in high-risk groups and in those who can afford the test.