Histological correlation of microcalcifications in breast biopsy specimens
Histological correlation of microcalcifications in breast biopsy specimens
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DOI：
10.1001/archsurg.134.7.712
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发表时间：
1999-07-01
影响因子：
--
通讯作者：
Lambert, PJ
中科院分区：
文献类型：
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作者：
Johnson, JM;Dalton, RR;Lambert, PJ
假设：通过乳房X光摄影发现的不可触及的恶性外观微钙化，从地理上讲是针对乳房内最重要的异常部位。设计：回顾了从1994年7月1日至1996年12月31日，403名连续接受乳腺活检的患者的前瞻性数据库，以确定为不确定的微钙化所做的活检。显示不典型增生、原位癌或浸润性癌的标本由1名病理学家鉴定和复查。单位：威斯康星州一家拥有450张床位的转诊社区教学医院。患者：在403例患者中，有167例(41.4%)在钼靶X线片上发现了不确定的微钙化。在167例活检标本中，61例(36.5%)含有不典型增生、原位癌或浸润性癌，并对这61例首次活检标本的载片进行了复习。主要观察指标：乳腺组织病理学表现与微钙化的关系。结果：在这61例标本中，发现82个区域为不典型增生、原位癌或浸润性癌。在复查幻灯片的82个区域中，43个(52%)的微钙化与这些区域相关，在61个活检标本中，33个(54%)的微钙化出现在最重要的异常中。结论：钼靶摄影确定的不确定的微钙化可能不是潜在乳腺疾病的确切位置。建议仔细评估整个活检标本，并密切跟踪良性病理发现的患者。
Hypothesis: Nonpalpable malignant-appearing microcalcifications discovered by mammography geographically target the location of the most important abnormality within the breast. Core needle or open biopsy of these microcalcifications will sample or remove underlying proliferative or invasive disease.Design: A prospective database of 403 consecutive patients undergoing breast biopsy for nonpalpable abnormalities from July 1, 1994, to December 31, 1996, was reviewed to identify biopsies done for indeterminate microcalcifications. Specimens showing atypical hyperplasia, carcinoma in situ, or invasive carcinoma were identified and reviewed by 1 pathologist. The position of microcalcifications larger than 100 mu m were recorded in reference to the histological findings.Setting: A 450-bed referral community teaching hospital in rural Wisconsin.Patients: Indeterminant microcalcifications were identified on mammograms in 167 (41.4%) of 403 patients. Sixty-one (36.5%) of 167 biopsy specimens contained atypical hyperplasia, carcinoma in situ, or invasive carcinoma, and the slides of these 61 initial breast biopsy specimens were reviewed.Main Outcome Measures: Relationship of breast histopathological findings to microcalcifications.Results: In these 61 specimens, 82 areas of atypical hyperplasia, carcinoma in situ, or invasive carcinoma were noted. The microcalcifications correlated with these areas in 43 (52%) of 82 areas on slide review and were present in the most important abnormality in 33 (54%) of 61 biopsy specimens.Conclusions: Indeterminant microcalcifications identified by mammography may not target the exact location of underlying breast disease. Careful evaluation of the entire biopsy specimen and close follow-up of patients with benign pathologic findings are recommended.