Sonographic differentiation of benign and malignant cystic lesions of the breast
Sonographic differentiation of benign and malignant cystic lesions of the breast
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DOI：
10.7863/jum.2007.26.1.47
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发表时间：
2007-01-01
影响因子：
2.3
通讯作者：
Yang, Seung Boo
中科院分区：
文献类型：
--
作者：
Chang, Yun-Woo;Kwon, Kwi Hyang;Yang, Seung Boo
Objective.本研究的目的是细分良性与恶性囊性肿块的超声表现类型，并根据超声表现与病理相关性确定适当的患者护理。方法.回顾性分析175例经病理证实的有症状的乳腺囊性病变的超声表现。囊性病变分为6型：单纯性囊肿（I型）、簇集性囊肿（II型）、囊隔较薄（III型）、复杂性囊肿（IV型）、囊壁/分隔或结节较厚的囊性肿块（V型）和囊实性肿块（VI型）。将超声检查结果与病理结果进行比较，并根据良恶性肿块的发生率进行评价。结果所有23例I型、15例II型、22例III型和35例IV型病例均经病理证实为良性。27例V型和53例VI型中分别有7例（25.9%）和33例（62.3%）被证实为恶性。我们分析了80例囊性肿块的形状和边缘的实性成分（类型V和VI）; 16（44%）的36个超声界定的肿块是恶性的。结论.因为超声检测到的单纯性囊肿（I型）、簇状囊肿（II型）和带有薄间隔的囊肿（III型）都是良性的，所以每年例行随访似乎是合理的。有症状的复杂囊肿（IV型）应根据临床症状进行抽吸并进行适当治疗。囊性肿块与实性成分（类型V和VI）应检查活检病理证实。
Objective. The purpose of this study was to subdivide the types of sonographic findings of benign versus malignant cystic masses and to determine appropriate patient care according to the sonographic findings with pathologic correlation. Methods. The sonographic findings of 175 symptomatic cystic breast lesions were pathologically proven and reviewed retrospectively. Cystic lesions were classified as 6 types: simple cysts (type I), clustered cysts (type II), cysts with thin septa (type III), complicated cysts (type IV), cystic masses with a thick wall/septa or nodules (type V), and complex solid and cystic masses (type VI). Sonographic findings were compared with the pathologic results and were evaluated according to the incidence of benign and malignant masses. Results. All 23 type I, 15 type II, 22 type III, and 35 type IV cases were pathologically proven to be benign. Seven (25.9%) of the 27 type V cases and 33 (62.3%) of the 53 type VI cases were proven to be malignant. We analyzed the shapes and margins of 80 cases of cystic masses with a solid component (types V and VI); 16 (44%) of 36 sonographically circumscribed masses were malignant. Conclusions. Because the sonographically detected simple cysts (type I), clustered cysts (type II), and cysts with thin septa (type III) were all benign, annual routine follow-up appears reasonable. Symptomatic complicated cysts (type IV) should be aspirated and appropriately treated according to clinical symptoms. Cystic masses with a solid component (types V and VI) should be examined by biopsy with pathologic confirmation.