Fat necrosis of the breast in the accelerated partial breast irradiation era: the need for a universal grading system
Fat necrosis of the breast in the accelerated partial breast irradiation era: the need for a universal grading system
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加速部分乳房照射时代的乳房脂肪坏死：需要一个通用的分级系统
DOI：
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发表时间：
2013
影响因子：
3.8
通讯作者：
A. Taghian
中科院分区：
文献类型：
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作者：
A. Russo;A. Taghian
乳腺脂肪坏死的报道越来越多，并被用作加速部分乳腺照射（APBI）治疗乳腺癌的试验终点。然而，最新版本的不良事件通用术语标准（CTCAE v4.0）中没有通用的毒性评分系统。这就要求调查人员采用自己的评分系统或不适当地使用现有的评分系统，并限制了对该实体的准确报告。乳腺脂肪坏死也会在临床医生中造成诊断的不确定性，并引起患者对复发的担忧。在这篇综述中，我们通过比较最近的APBI试验和文献来解决脂肪坏死发生率增加的问题。发病机制，症状，临床和放射学诊断，发展脂肪坏死的临床预测，管理和随访也进行了讨论。最后，我们提出了一个简化和通用的评分系统报告脂肪坏死。
Fat necrosis of the breast is increasingly reported and used as a trial endpoint in the treatment of breast cancer with accelerated partial breast irradiation (APBI). Yet, there is no universal toxicity scoring system within the latest version of the Common Terminology Criteria for Adverse Events (CTCAE v4.0). This requires investigators to adopt their own scoring system or improperly use those that exist, and limits accurate reporting of this entity. Fat necrosis of the breast also creates diagnostic uncertainty among clinicians and concern of recurrence among patients. In this review, we address the question of increasing incidence of fat necrosis through the comparison of recent APBI trials and literature. The pathogenesis, symptoms, clinical and radiologic diagnosis, clinical predictors of developing fat necrosis, management and follow-up are also discussed. Lastly, we propose a simplified and universal scoring system for the reporting of fat necrosis.