年轻癌症患者术前乳腺超声和磁共振成像评估肿瘤大小的准确性比较

Sang Yull Kang, E. Choi, Jung Hee Byon, H. Ahn, H. Youn, S. Jung
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摘要

接收日期2020年3月5日修订日期2020年4月31日接受日期2020年6月6日目的:年轻女性的乳腺癌症值得特别考虑,如致密乳房、更积极的进展和肿瘤整形手术。磁共振成像(MRI)是一种比超声(US)更新的成像方式,但MRI在致密乳房患者中的作用仍然存在争议。本比较研究分析了年轻癌症患者术前放疗与术后病理肿瘤大小的关系。方法:对2016年1月至2018年12月在45岁及以下患者中诊断的所有乳腺癌进行回顾性分析。将乳腺超声和MRI上获得的肿瘤大小测量值与最终病理学结果中获得的测量值进行准确性比较。影像学检查仅有微钙化的患者和接受过新辅助化疗的患者被排除在外。结果:本研究共纳入103例癌症患者。在采用两种成像方式的103例乳腺癌中,86例(83.5%)为浸润性导管癌,17例(16.5%)为导管原位癌。MRI上测量的平均肿瘤大小显著大于病理学上测量的肿瘤大小(18.5±11.0 mm vs.16.6±8.5 mm),而US上测量的大小与病理学上测得的大小没有显著差异(16.5±9.5 mm vs.166±8.5毫米)。MRI测量的肿瘤大小大于US测量的肿瘤尺寸。结论:US测量的45岁及以下患者的肿瘤大小比MRI测量的更准确。
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Comparative Accuracy of Preoperative Tumor Size Assessment on Breast Ultrasonography and Magnetic Resonance Imaging in Young Breast Cancer Patients
Received March 5, 2020 Revised March 31, 2020 Accepted April 6, 2020 Purpose: Breast cancer in young women deserves special consideration, such as dense breast, more aggressive progression, and oncoplastic surgery. Magnetic resonance imaging (MRI) is a more recent modality than ultrasonography (US), but the role of MRI in patients with a dense breast is still controversial. This comparative study analyzed the relationship between the preoperative radiological and the postoperative pathological tumor size for young breast cancer patients. Methods: All breast cancers diagnosed in patients 45 years or younger from January 2016 to December 2018 were reviewed. Tumor size measurements obtained on breast US and MRI were compared for accuracy with those obtained in the final pathology results. Patients with only microcalcification on imaging modalities and those who had undergone neoadjuvant chemotherapy were excluded. Results: A total of 103 breast cancer patients were included in this study. Of the 103 breast cancers with both imaging modalities performed, 86 (83.5%) were infiltrating ductal carcinomas and 17 (16.5%) were ductal carcinoma in situ. The mean tumor size measured on MRI was significantly greater than that measured on pathology (18.5 ± 11.0 mm vs. 16.6 ± 8.5 mm), whereas the sizes measured on US was not significantly different from that measured on pathology (16.5 ± 9.5 mm vs. 16.6 ± 8.5 mm). The tumor size measured on MRI was greater than that measured on US. Conclusion: Measurements taken by US were more accurate in measuring the tumor size in patients 45 years of age or younger than MRI.
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