Papillary lesions of the breast diagnosed at percutaneous sonographically guided biopsy: Comparison of sonographic features and biopsy methods
Papillary lesions of the breast diagnosed at percutaneous sonographically guided biopsy: Comparison of sonographic features and biopsy methods
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DOI：
10.2214/ajr.07.2664
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发表时间：
2008-03-01
影响因子：
5
通讯作者：
Gong, Gyungyub
中科院分区：
文献类型：
--
作者：
Shin, Hee Jung;Kim, Hak Hee;Gong, Gyungyub
目标。我们研究的目的是回顾性评估超声特征和活检在经皮超声引导活检诊断的乳头状病变患者的治疗中的潜在作用。材料和方法。手术或超声随访（>= 2年）123名妇女（年龄范围21-75岁，平均年龄47岁），在7年期间超声引导核心针或真空辅助活检诊断出124个乳头状病变。手术切除结果或随访2年无变化的超声检查作为参考标准。我们回顾了超声特征、活检结果以及手术或超声随访。采用Fisher精确检验对超声特征的差异进行统计学分析。每BI-RADS分类的癌症发病率如下：第3类，0 (0%)/ 21；4a类，14 (17%)85；4b类，11个中的4个（36%）；4c类，五个中的一个（20%）；第5类，两个中的一个（50%）。超声检查中区分良恶性乳头状病变的两个特征是回声模式和肿块边缘。芯针活检的敏感性为28%，特异性为100%，而真空辅助活检的敏感性和特异性均为100%。在117个活检结果为良性的病变中，17%的良性乳头状瘤、24%的非典型乳头状瘤和0%的多发性乳头状瘤可转为恶性或高危病变。对乳头状病变的诊断，真空辅助活检比芯针活检更准确，超声特征和芯针活检都不够准确。因此，为了准确诊断乳头状病变，应行手术切除。
OBJECTIVE. The objective of our study was to retrospectively assess the potential role of sonographic features and biopsy in the management of patients with papillary lesions diagnosed at percutaneous sonographically guided biopsy.MATERIALS AND METHODS. Surgical or sonographic follow-up (>= 2 years) was available in 123 women (age range, 21-75 years; mean age, 47 years) with 124 papillary lesions diagnosed at sonographically guided core needle or vacuum-assisted biopsy during a 7-year period. Surgical excision results or follow-up sonograms with no change at the 2-year follow-up served as the reference standard. We reviewed the sonographic features, biopsy results, and surgical or sonographic follow-up. Statistical analysis was performed using the Fisher's exact test for the difference of sonographic features.RESULTS. Cancer incidence per BI-RADS category was as follows: category 3, zero (0%) of 21; category 4a, 14 (17%) of 85; category 4b, four (36%) of 11; category 4c, one (20%) of five; and category 5, one (50%) of two. On sonography, two features distinguishing benign from malignant papillary lesions were echo pattern and margins of masses. Core needle biopsy gave a sensitivity of 28% and specificity of 100%, whereas both sensitivity and specificity were 100% with vacuum-assisted biopsy. Of 117 lesions with benign biopsy results, upgrade to malignancy or high-risk lesion was found in 17% of benign papillomas, 24% of atypical papillomas, and 0% of multiple papillomas.CONCLUSION. Vacuum-assisted biopsy was more accurate than core needle biopsy in diagnosing papillary lesions, and both sonographic features and core needle biopsy were not sufficiently accurate. Therefore, surgical excision should be performed for the accurate diagnosis of papillary lesions.