Radiological and Histopathological Correlation by Age in among Women with Breast Lesions: A Single-Center Study

Öz

Background: This study aimed to compare pathology results and pre-biopsy radiological diagnoses of patients who underwent breast biopsy, and to determine whether there are any changes according to age. Materials and Methods: The study included 217 patients (aged 13-87) who underwent ultrasonography (US)-guided biopsy. Pre-biopsy ultrasonographic features and Breast Imaging Reportingand Data Systems (BIRADS) score of the lesions were recorded.Fine-needle aspiration was performed for cystic lesions and tru-cut biopsy for solid lesions. Histopathology results were groupedaccording to benign and malignant lesion types. The results werecompared by dividing into two groups under 40 years old and over 40 years old. Results: In this study, 50% of the lesions were malignant (meanage: 54.9), and 50% were benign (mean age: 44.9). The mostcommon benign and malignant lesions were fibroadenoma andinvasive ductal carcinoma. The lesion had irregular contours,microcalcification and the presence of axillary lymphadenopathywere statistically significant for malignancy (p<0.001). On US,15.5% of lesions (n=34) were not clearly demarcated from thesurrounding fibroglandular tissue (non-mass lesion). Of these,50% were diagnosed as cancer, 8.8% as idiopathic granulomatousmastitis, and 8.8% as fibrocystic changes. The result of the Cohen'sKappa coefficient for the agreement between the BIRADS systemand pathological findings is 0.718 (sensitivity: 1, specificity:0.71, positive predictive value: 0.78, negative predictive value:1, accuracy rate: 0.85) (p<0.05). In logistic regression analysis,91.3% accuracy was obtained in the patient's age, diameter,lateralization, contour of the mass, presence of microcalcification,and axillary lymphadenopathy parameters. Conclusions: The radiopathological correlation of the diagnosiswas found to be high rate. Since invasive breast carcinomashows sonographic similarities with benign conditions such asgranulomatous mastitis and fibrocystic changes, histopathologicaldiagnosis is recommended for suspicious lesions that can not beclearly demarcated.

Anahtar Kelimeler

• Breast cancer
• BIRADS
• Histopathological type
• Ultrasonography

Meme Lezyonlu Kadınlarda Yaşa Göre Radyolojik ve Histopatolojik Korelasyon: Tek Merkezli Bir Çalışma

Öz

Amaç: Bu çalışmada, meme biyopsisi yapılan hastaların patoloji sonuçları ile biyopsi öncesi radyolojik tanılarının karşılaştırılması ve yaşa göre herhangi bir değişiklik olup olmadığının belirlenmesi amaçlandı. Materyal ve metod: Çalışmaya ultrasonografi (US) rehberliğinde biyopsi yapılan 217 hasta (yaşları: 13-87) dahil edildi. Lezyonların biyopsi öncesi ultrasonografik özellikleri ve Meme Görüntüleme Raporlama ve Veri Sistemleri (BIRADS) skorları kaydedildi. Kistik lezyonlar için ince iğne aspirasyonu, solid lezyonlar için ise tru-cut biyopsi uygulandı. Histopatoloji sonuçları benign ve malign lezyon tiplerine göre gruplandırıldı. Sonuçlar 40 yaş altı ve 40 yaş üstü olmak üzere iki gruba ayrılarak karşılaştırıldı. Bulgular: Bu çalışmada lezyonların %50’si malign (ortalama yaş: 54,9), %50'si ise benign (ortalama yaş: 44,9) idi. En sık görülen benign ve malign lezyonlar fibroadenom ve invaziv duktal karsinomdu. Lezyonun düzensiz konturları, mikrokalsifikasyonu ve aksiller lenfadenopati varlığı malignite açısından istatistiksel olarak anlamlıydı (p<0,001). US’de lezyonların %15,5’i (n=34) çevre fibroglandüler dokudan net olarak ayrılamıyordu (kitlesel olmayan lezyon). Bunların %50’si kanser, %8,8’i idiyopatik granülomatöz mastit ve %8,8’i fibrokistik değişiklik olarak teşhis edildi. BIRADS sistemi ile patolojik bulgular arasındaki uyum için Cohen’in Kappa katsayısının sonucu 0,718’dir (duyarlılık: 1, özgüllük: 0,71, pozitif öngörü değeri: 0,78, negatif öngörü değeri: 1, doğruluk oranı: 0,85) (p<0,05). Lojistik regresyon analizinde, hastanın yaşı, çapı, lokalizasyonu, kitlenin konturu, mikrokalsifikasyon varlığı ve aksiller lenfadenopati parametrelerinde %91,3 doğruluk elde edildi. Sonuç: Tanıdaki radyopatolojik korelasyon yüksek oranda bulundu. İnvaziv meme karsinomu, granülomatöz mastit ve fibrokistik değişiklikler gibi iyi huylu durumlarla US benzerlikler gösterdiğinden, net olarak ayrılamayan şüpheli lezyonlar için histopatolojik tanı önerilmektedir.

Anahtar Kelimeler

• Meme kanseri
• BIRADS
• Histopatolojik tip
• Ultrasonografi

Kaynakça

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