Unnecessary Biopsy For Fibroadenomas, How Can We Decrease Its Rate?

Year 2017, Volume: 4 Issue: 3, 13 - 18, 01.12.2017

Emrah Doğan , Leyla Tekin , Neşat Çullu , Murat Polat

Abstract

Fibroadenoma (FA) is
benign form of tumors of the breast with a very low risk of transformation to
malignity. It is very common among young women and incidence drops with age.
Diagnosis is often made by ultrasonography (US). Instead of excision for
diagnosis, following is made by imaging. Currently, FA amount for about half of
the biopsies of breast.  The objective of
our study is to find by which mean we can decrease the rate of unnecessary
biopsies. We made a retrospective study on 39 patients labelled as FA (mean age
48.8±7.7 years). We analyzed the features of lesions in US: size, localization,
contour, orientation, homogeneity, echogenicity, single or multiple, presence
or absence of calcifications. We classified our masses according to BIRADS
categorization and also calculated the rate of masses according to indications
of biopsies. Concerning the ultrasonographic description of FA’s features, all
of our findings were compatible with literature. Except one patient, all of
them were classified as less suspicious according to BIRADS categorization. 2/3
of biopsies in our sample were made in the first examination and 1/3 presented
suspicious features. A high amount of biopsy is indicated in the first contact
with patients because there is no previous examination to refer to. We suggest
to not wait for patient to be aware of the mass or for systematic examination
set at the age of 40 and to make earlier US in purpose to have a documented
reference of masses’ features which are well established according to
literature in order to avoid unnecessary biopsies. 

Keywords

Fibroadenoma, Breast, Tru-cut Biopsy, Ultrasonography

Fibroadenomlara Yapılan Gereksiz Biyopsiler, Nasıl Oranlarını Düşürebiliriz?

Abstract

Fibroadenoma malign
transformasyon riski çok düşük olan benign formda bir meme tümörüdür. Genç
yaşta daha yaygındır ve insidansı yaş ile düşer. Tanısı sıklıkla ultrasonografi
ile konur. Eksizyon yerine genellikle radyolojik izlem yapılır. Buna rağmen
meme biyopsilerinin yarısı fibroadenomlara yapılmaktadır. Araştırmamızın konusu
fibroadenomlara yapılan gereksiz biyopsilerin nasıl düşürülebileceği
hakkındadır. Araştırma Fibroadenom
tanısı almış 39 hastayı kapsayan retrospektif bir çalışmadır. (ortalama yaş
48.8±7.7). Ultrasonografi ile lezyonların özellikleri
analiz edildi. Boyut, lokalizasyon, kontür, oryantasyon, homojenite, ekojenite,
tek ya da multipl olması, kalsifikasyon özelliklerine göre sınıflandırıldı .
Ayrıca  lezyonların BIRADS grupları
belirtildi. Son olarak lezyonlar biyopsi yapılma nedenlerine göre
sınıflandırıldı. Lezyonların
ultrasonografik özellikleri ile ilgili tüm bulgular literatürle uyumluydu. Bir
hasta hariç tüm hastalar BIRADS grubuna göre düşük riskli gruptaydı.
Araştırmamızda biyopsi yapılan hastaların 2/3’ü ilk kez ultrasonografik takibe
giren hastalardı ve 1/3’ü şüpheli özelliklere sahipti. Literatürde belirtilen biyopsi endikasyonlarına göre hasta 40
yaşına gelmeden  ya da kitle ele gelmeden
yapılan bir ultrasonografik muayene ile lezyona ait referans bir döküman
bulunduğunda  fibroadenomlara yapılan
gereksiz biyopsi oranı azaltılabilir.

Keywords

Fibroadenoma, Meme, Tru-cut Biyopsi, Ultrasonografi

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