Short-Term Follow-Up of Palpable Breast Lesions With Benign Imaging Features: Evaluation of 375 Lesions in 320 Women
Short-Term Follow-Up of Palpable Breast Lesions With Benign Imaging Features: Evaluation of 375 Lesions in 320 Women
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DOI：
10.2214/ajr.09.2811
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发表时间：
2009-12-01
影响因子：
5
通讯作者：
Bovbjerg, Viktor E.
中科院分区：
文献类型：
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作者：
Harvey, Jennifer A.;Nicholson, Brandi T.;Bovbjerg, Viktor E.
OBJECTIVE.本研究的目的是评估具有良性影像学特征的可触及肿块短期随访的可行性。回顾性分析了1997年7月至2003年12月期间所有可触及的圆形、椭圆形或分叶肿块，边界清楚，超声回声均匀，建议短期随访的女性病例。通过超声和/或乳房X线摄影和重点临床检查进行评价。通过至少12个月的影像学或临床随访评估结局。可触及病灶的癌症发生率与建议短期随访的不可触及病灶的癌症发生率进行比较。在379名妇女中，确定了443个具有良性特征的可触及肿块，建议进行短期随访。320名妇女的375个肿块的结局数据可用。通过乳腺X线摄影和超声（n = 186）或单独超声（n = 189）评价病变。肿块通常只能通过超声波识别（n = 258，68.8%）;卵圆形（n = 275，73.3%），在乳房X线片上与正常乳腺组织密度相等（n = 95，117例，81.2%），低回声（372次超声检查中，n = 336，90.3%）;前瞻性地认为是纤维腺瘤（n = 304，81.1%）。85个病变（22.7%）进行活检后不久，评估，1个1.5毫米导管原位癌被诊断。在随访时（平均2.7年），26处病变（6.9%）生长。26个病灶中的24个进行了活检，没有诊断出癌症。可触及肿块（0.3%）和不可触及肿块（1.6%）的总体癌症患病率相似。短期随访费用低于活检。短期随访是一个合理的替代活检可触及的乳腺病变与良性影像学特征，特别是年轻女性可能纤维腺瘤。
OBJECTIVE. The purpose of this study was to evaluate the feasibility of short-term follow-up of palpable masses that have benign imaging features.MATERIALS AND METHODS. The cases of all women with round, oval, or lobular palpable masses with circumscribed margins and homogeneous ultrasound echotexture for which short-term follow-up was recommended from July 1997 through December 2003 were retrospectively identified. Evaluation was by ultrasound and/or mammography and focused clinical examination. Outcome was assessed with imaging or clinical follow-up lasting at least 12 months. The cancer incidence for palpable lesions was compared with that for non-palpable lesions recommended for short-term follow-up.RESULTS. In 379 women, 443 palpable masses with benign features for which short-term follow-up was recommended were identified. Outcome data were available on 375 masses in 320 women. Lesions were evaluated with mammography and ultrasound (n = 186) or ultrasound alone (n = 189). Masses were typically identified only with ultrasound (n = 258, 68.8%); were oval (n = 275, 73.3%), of equal density to normal breast tissue on mammograms (n = 95 on 117 mammograms, 81.2%), and hypoechoic (n = 336 in 372 ultrasound examinations, 90.3%); and were prospectively believed to be fibroadenoma (n = 304, 81.1%). Eighty-five lesions (22.7%) were biopsied soon after evaluation, and one 1.5-mm ductal carcinoma in situ was diagnosed. At follow-up (mean, 2.7 years), 26 lesions (6.9%) had grown. Twenty-four of the 26 lesions were biopsied, and no cancer was diagnosed. The overall cancer prevalence was similar for palpable (0.3%) and nonpalpable (1.6%) masses. The cost of short-term follow-up was less than that of biopsy.CONCLUSION. Short-term follow-up is a reasonable alternative to biopsy of palpable breast lesions with benign imaging features, particularly for young women with probable fibroadenoma.