高级别乳腺导管原位癌伴退行性改变:影像学和临床病理表现。

Merve Gursoy, Aysenur Oktay, Ozge Aslan, Osman Zekioglu
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引用次数: 0

摘要

目的:肿瘤消退被定义为导致肿瘤种群消除的变化的连续性,并反映为导管周围纤维化和导管内肿瘤衰减。本研究的目的是描述高级别乳腺导管原位癌(DCIS)伴退行性改变(RC)的放射学和临床病理特征。材料与方法:选取32例高级别DCIS伴活检标本RC并行切除的病例。根据乳腺影像学报告和数据系统(BI-RADS)词典,回顾性回顾了病例的乳房x线摄影,超声检查(US)和磁共振成像(MRI)结果。记录临床和组织病理学结果[粉刺坏死,雌激素受体(ER),孕激素受体(PR),人表皮生长因子受体2 (HER2)状态和Ki-67增殖指数]。评估手术切除及淋巴结受累后升级为浸润性癌的比率。结果:乳房x线摄影最常见的发现是微钙化(68.8%)。超声检查最常见的表现是微钙化(21.9%),其次是微钙化和低回声区(18.7%)。在MRI上,大多数病变表现为块状非肿块增强,呈节段性分布。ER/PR阴性(53.1%,65.6%),HER2阳性(56.3%)和高Ki-67(62.5%),已知与更具有攻击性行为相关,比例更高。升级为浸润性癌的比例为21.8%。结论:DCIS合并RC病变在x光和超声检查中最常表现为微钙化。MRI特征与其他DCIS病变难以区分。具有RC病变的DCIS的生物标志物状态反映了更强的侵袭性行为和更高的浸润性癌升级率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
High-Grade Ductal Carcinoma In Situ of the Breast With Regressive Changes: Radiological and Clinicopathological Findings.

Objective: Tumour regression is defined as continuity of changes leading to the elimination of a neoplastic population and is reflected as periductal fibrosis and intraductal tumour attenuation. The aim of this study was to describe the radiological and clinicopathological characteristics of high-grade breast ductal carcinoma in situ (DCIS) with regressive changes (RC).

Materials and methods: Thirty-two cases of high-grade DCIS with RC on biopsy specimens followed by excision were included. The mammographic, ultrasonographic (US), and magnetic resonance imaging (MRI) findings of cases were retrospectively reviewed according to the breast imaging reporting and data system (BI-RADS) lexicon. Clinical and histopathological findings [comedonecrosis, estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) status and Ki-67 proliferation index] were recorded. The rate of upgrade to invasive cancer after surgical excision and lymph node involvement were evaluated.

Results: The most common mammographic finding was microcalcifications alone (68.8%). The most frequently seen findings on US were microcalcifications only (21.9%), followed by microcalcifications and hypoechoic area (18.7%). On MRI, most lesions presented as clumped non-mass enhancement with segmental distribution. ER/PR negativity (53.1%, 65.6%), HER2 positivity (56.3%) and high Ki-67 (62.5%), which are known to be associated with more aggressive behavior, were found to be proportionally higher. The rate of upgrade to invasive cancer was 21.8%.

Conclusion: DCIS with RC lesions present most often as microcalcifications alone on both mammography and US. MRI features are not distinguishable from those of other DCIS lesions. DCIS with RC lesions show biomarker status reflecting more aggressive behavior and high upgrade rate to invasive cancer.

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