良性一致磁共振成像引导下乳腺活检的临床结果

IF 2.9 3区 医学 Q2 ONCOLOGY Clinical breast cancer Pub Date : 2024-06-18 DOI:10.1016/j.clbc.2024.06.009
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引用次数: 0

摘要

核磁共振成像引导下的活检是仅通过核磁共振成像发现乳腺影像的标准治疗方法。虽然有多项研究报告称核磁共振成像引导下乳腺活检的假阴性率为零,但在良性一致的核磁共振成像引导下活检后的成像随访方面却存在不同的实践模式。本研究评估了一家医疗机构的良性MRI引导活检结果。这项经 IRB 批准的回顾性研究纳入了 2014 年 11 月 1 日至 2020 年 8 月 31 日期间在 MRI 引导下进行乳腺病变活检的患者。只有图像一致、组织病理学为良性的乳腺病变以及通过核磁共振成像或切除术进行随访的病变才被纳入研究范围。在符合纳入标准的216名患者的275个病灶中,有274个病灶接受了磁共振成像随访(范围为5-79个月;平均为25.5个月),随访结果显示为良性或稳定特征。在 275 个病灶中,有一个病灶(0.4%)为 6 mm 局灶性非肿块强化,在最初的 MRI 引导下活检发现为纤维囊性病变后,最终发现为恶性肿瘤。该病灶在 6 个月的磁共振随访中保持稳定,但在 18 个月时增大。超声引导下的再次活检结果为浸润性导管癌(IDC)和导管原位癌(DCIS)。乳腺核磁共振引导活检的假阴性率很低。我们从总共 275 个病灶中发现的单个恶性肿瘤的假阴性率为 0.4%。该数据还支持较常见的 6 个月随访间隔更长的随访间隔,以评估间隔变化。
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Clinical Outcomes of Benign Concordant MRI-Guided Breast Biopsies

Introduction

MRI-guided biopsy is the standard of care for breast imaging findings seen only by MRI. Although a non-zero false-negative rate of MRI-guided breast biopsy has been reported by multiple studies, there are varied practice patterns for imaging follow-up after a benign concordant MRI guided biopsy. This study assessed the outcomes of benign concordant MRI-guided biopsies at a single institution.

Patients and Methods

This IRB-approved, retrospective study included patients with MRI-guided biopsies of breast lesions from November 1, 2014, to August 31, 2020. Only image-concordant breast lesions with benign histopathology and those follow up with MRI imaging or excision were included in the study.

Results

Out of 275 lesions in 216 patients that met the inclusion criteria, 274 lesions were followed with MRI (range, 5-79 months; average, 25.5 months) and showed benign or stable features upon follow-up. One out of 275 lesions (0.4%), a 6 mm focal nonmass enhancement, was ultimately found to represent malignancy after initial MRI-guided biopsy yielded fibrocystic changes. The lesion was stable at a 6-month follow-up MRI but increased in size at 18 months. Repeat biopsy by ultrasound guidance yielded invasive ductal carcinoma (IDC) and ductal carcinoma in situ (DCIS).

Conclusion

Breast MRI-guided biopsy has a low false-negative rate. Our single malignancy from a total of 275 lesions gives a false negative rate of 0.4%. This data also supports a longer follow-up interval than the commonly performed 6-month follow-up, in order to assess for interval change.

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来源期刊
Clinical breast cancer
Clinical breast cancer 医学-肿瘤学
CiteScore
5.40
自引率
3.20%
发文量
174
审稿时长
48 days
期刊介绍: Clinical Breast Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of breast cancer. Clinical Breast Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of breast cancer. The main emphasis is on recent scientific developments in all areas related to breast cancer. Specific areas of interest include clinical research reports from various therapeutic modalities, cancer genetics, drug sensitivity and resistance, novel imaging, tumor genomics, biomarkers, and chemoprevention strategies.
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