Araştırma Makalesi
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Radiologic-pathologic correlations of biopsies of BIRADS III breast lesions performed under guidance of ultrasonography

Yıl 2019, , 409 - 414, 01.12.2019
https://doi.org/10.21601/ortadogutipdergisi.510396

Öz

Purpose: In our retrospective study, we aimed to evaluate the biopsied BIRADS III breast lesions due to enlargement on ultrasonography in patients with risk factors. We have compared the pathologic results with sonographic definitions to find an association.
Materials and Methods: We have retrospectively scanned hospital records and obtained the radiologic and pathologic data belong to 67 patients. We have deduced sonographic terms defining the lesions from radiologic reports and compared the data with pathology results to find a statistically significant association between sonographic definitions and pathologic diagnosis.
Results: All histopathology-proved fibroadenoma, fibrosis and invasive ductal carcinoma were statistically associated with “smooth margins” on ultrasonography (p:0.034). Term of “lobulated contour” was not statistically linked with any of the pathologic entities (p:0.947). Fibrocystic component was significantly present in fibrocysts and infections/abscesses (p<0.001).
Conclusions: Patients in risk group who had lesions with smooth margins on ultrasonography and classified as BIRDAS III might have diagnosis of invasive ductal carcinoma along with benign entities. Thus, we consider that biopsy is still the most useful diagnostic tool in patients with risk factors as smooth margins on ultrasound might not refer to its benign nature.

Kaynakça

  • Rao AA, Feneis J, Lalonde C, Ojeda-Fournier H. A Pictorial Review of Changes in the BI-RADS Fifth Edition. Radiographics 2016; 36: 623–39.
  • Lee KA, Talati N, Oudsema R, Steinberger S, Margolies LR. BI- RADS 3: Current and Future Use of Probably Benign. Curr Radiol Rep 2018; 6: 5.
  • Jung I, Kim MJ, Moon HJ, Yoon JH, Kim EK. Ultrasonography-guided 14-gauge core biopsy of the breast: results of 7 years of experience. Ultrasonography 2018; 37: 55–62.
  • Ozmen V, Ozcinar B, Karanlik H, Cabioglu N, Tukenmez M, Disci R, ve ark. Breast cancer risk factors in Turkish women--a University Hospital based nested case control study. World J Surg Oncol 2009; 7: 37.
  • Stavros AT, Thickman D, Rapp CL, Dennis MA, Parker SH, Sisney GA. Solid breast nodules: use of sonography to distinguish between benign and malignant lesions. Radiology 1995; 196: 123–34.
  • D’Orsi C, Sickles EA, Mendelson EB, Morris EA. Breast Imaging Reporting and Data System: ACR BI-RADS breast imaging atlas. 5th ed. Reston, Va: American College of Radiology, 2013.
  • Berg WA, Blume JD, Cormack JB, Mendelson EB, Lehrer D, Bohm-Velez M, ve ark. Combined screening with ultrasound and mammography vs mammography alone in women at elevated risk of breast cancer. JAMA 2008; 299: 2151–63.
  • Hong AS, Rosen EL, Soo MS, Baker JA. BI-RADS for sonography: positive and negative predictive values of sonographic features. AJR 2005; 184: 1260–5.
  • Raza S, Goldkamp AL, Chikarmane SA, Birdwell RL. US of breast masses categorized as BI-RADS 3, 4, and 5: pictorial review of factors influencing clinical management. Radiographics 2010; 30: 1199–213.
  • Raza S, Chikarmane SA, Neilsen SS, Zorn LM, Birdwell RL. BIRADS 3, 4, and 5 lesions: value of US in management—followup and outcome. Radiology 2008; 248: 773–81.
  • Gordon PB, Gagnon FA, Lanzkowsky L. Solid breast masses diagnosed as fibroadenoma at fine-needle aspiration biopsy: acceptable rates of growth at long-term follow-up. Radiology. 2003; 229: 233–8.
  • Chae EY, Cha JH, Shin HJ, Choi WJ, Kim HH. Reassessment and Follow-Up Results of BI-RADS Category 3 Lesions Detected on Screening Breast Ultrasound. AJR Am J Roentgenol 2016; 206: 666–72.
  • Ozmen V. Breast cancer in the World and Turkey. J Breast Health 2008; 4: 6–12.
  • Fuhrman GM, Cederbom GJ, Bolton JS, King TA, Duncan JL, Champaign JL, ve ark. Image-guided core-needle breast biopsy is an accurate technique to evaluate patients with nonpalpable imaging abnormalities. Ann Surg 1998; 227: 932–9.
  • Liberman L. Clinical management issues in percutaneous core breast biopsy. Radiol Clin North Am 2000; 38: 791–807.
  • Bassett LW, Mahoney MC, Apple SK. Interventional breast imaging: current procedures and assessing for concordance with pathology. Radiol Clin North Am 2007; 45: 881–94.
  • Liberman L, Feng TL, Dershaw DD, Morris EA, Abramson AF. US guided core breast biopsy: use and cost-effectiveness. Radiology 1998; 208: 717–23.
  • Philpotts LE, Hooley RJ, Lee CH. Comparison of automated versus vacuum-assisted biopsy methods for sonographically guided core biopsy of the breast. AJR Am J Roentgenol 2003; 180: 347–51.
  • White RR, Halperin TJ, Olson JA Jr, Soo MS, Bentley RC, Seigler HF. Impact of core-needle breast biopsy on the surgical management of mammographic abnormalities. Ann Surg 2001; 233: 769–77.

BIRADS III meme lezyonlarına ultrasonografi eşliğinde yapılan biyopsilerde radyolojik patolojik korelasyon

Yıl 2019, , 409 - 414, 01.12.2019
https://doi.org/10.21601/ortadogutipdergisi.510396

Öz

Amaç: Çalışmamızda risk grubundaki hastalarda ultrasonografide tanımlanan ve boyut artışı gösteren BIRADS III lezyonlara yapılan biyopsileri geriye dönük olarak değerlendirerek bu lezyonların patoloji sonuçları ile tarif için kullanılan terimler arasında bir bağıntının varlığını araştırdık.
Yöntemler: Hastane verileri geriye doğru taranarak, patolojik ve radyoloji verilerine ulaşılabilen 67 hastanın ultrasonografi raporlarından lezyonu tarif eden terimler çıkarıldı. Elde edilen bilgiler ile hastaların biyopsi sonuçları istatistiksel olarak karşılaştırılarak lezyonun sonografik tarifi ile patoloji sonucu arasında bir ilişki araştırıldı.
Bulgular: Patolojik olarak fibroadenom, fibrozis ve invaziv duktal karsinom olarak tespit edilen olguların ultrasonografi raporlarında istatistiksel olarak anlamlı olarak daha yüksek oranda “düzgün sınırlı” ifadesi geçmekte idi (p:0,034). “Lobüle konturlu” olarak tarif edilen lezyonlar ile hiçbir tanı grubu arasında ilişki saptanmadı (p:0,947). Fibrokistik değişiklik alanı ve enfeksiyon/apse olarak patoloji raporu olan lezyonlar, ultrasonografide “kistik komponent” tarifi ile ilişkiliydi (p<0,001).
Sonuçlar: Risk grubundaki hastalarda USG ile BIRADS III olarak tanımlanan ve düzgün sınırlı olarak tanımlanan lezyonların benign tanıların yanı sıra invaziv duktal karsinom ile de ilişkili olduğunu bulduk. Buradan hareketle risk grubundaki hastalarda lezyonun düzgün sınırlı olmasının lezyonun benign natürüne işaret etmediğini ve bu hastalarda yine en net tanı aracının biyopsi oluğunu savunuyoruz.

Kaynakça

  • Rao AA, Feneis J, Lalonde C, Ojeda-Fournier H. A Pictorial Review of Changes in the BI-RADS Fifth Edition. Radiographics 2016; 36: 623–39.
  • Lee KA, Talati N, Oudsema R, Steinberger S, Margolies LR. BI- RADS 3: Current and Future Use of Probably Benign. Curr Radiol Rep 2018; 6: 5.
  • Jung I, Kim MJ, Moon HJ, Yoon JH, Kim EK. Ultrasonography-guided 14-gauge core biopsy of the breast: results of 7 years of experience. Ultrasonography 2018; 37: 55–62.
  • Ozmen V, Ozcinar B, Karanlik H, Cabioglu N, Tukenmez M, Disci R, ve ark. Breast cancer risk factors in Turkish women--a University Hospital based nested case control study. World J Surg Oncol 2009; 7: 37.
  • Stavros AT, Thickman D, Rapp CL, Dennis MA, Parker SH, Sisney GA. Solid breast nodules: use of sonography to distinguish between benign and malignant lesions. Radiology 1995; 196: 123–34.
  • D’Orsi C, Sickles EA, Mendelson EB, Morris EA. Breast Imaging Reporting and Data System: ACR BI-RADS breast imaging atlas. 5th ed. Reston, Va: American College of Radiology, 2013.
  • Berg WA, Blume JD, Cormack JB, Mendelson EB, Lehrer D, Bohm-Velez M, ve ark. Combined screening with ultrasound and mammography vs mammography alone in women at elevated risk of breast cancer. JAMA 2008; 299: 2151–63.
  • Hong AS, Rosen EL, Soo MS, Baker JA. BI-RADS for sonography: positive and negative predictive values of sonographic features. AJR 2005; 184: 1260–5.
  • Raza S, Goldkamp AL, Chikarmane SA, Birdwell RL. US of breast masses categorized as BI-RADS 3, 4, and 5: pictorial review of factors influencing clinical management. Radiographics 2010; 30: 1199–213.
  • Raza S, Chikarmane SA, Neilsen SS, Zorn LM, Birdwell RL. BIRADS 3, 4, and 5 lesions: value of US in management—followup and outcome. Radiology 2008; 248: 773–81.
  • Gordon PB, Gagnon FA, Lanzkowsky L. Solid breast masses diagnosed as fibroadenoma at fine-needle aspiration biopsy: acceptable rates of growth at long-term follow-up. Radiology. 2003; 229: 233–8.
  • Chae EY, Cha JH, Shin HJ, Choi WJ, Kim HH. Reassessment and Follow-Up Results of BI-RADS Category 3 Lesions Detected on Screening Breast Ultrasound. AJR Am J Roentgenol 2016; 206: 666–72.
  • Ozmen V. Breast cancer in the World and Turkey. J Breast Health 2008; 4: 6–12.
  • Fuhrman GM, Cederbom GJ, Bolton JS, King TA, Duncan JL, Champaign JL, ve ark. Image-guided core-needle breast biopsy is an accurate technique to evaluate patients with nonpalpable imaging abnormalities. Ann Surg 1998; 227: 932–9.
  • Liberman L. Clinical management issues in percutaneous core breast biopsy. Radiol Clin North Am 2000; 38: 791–807.
  • Bassett LW, Mahoney MC, Apple SK. Interventional breast imaging: current procedures and assessing for concordance with pathology. Radiol Clin North Am 2007; 45: 881–94.
  • Liberman L, Feng TL, Dershaw DD, Morris EA, Abramson AF. US guided core breast biopsy: use and cost-effectiveness. Radiology 1998; 208: 717–23.
  • Philpotts LE, Hooley RJ, Lee CH. Comparison of automated versus vacuum-assisted biopsy methods for sonographically guided core biopsy of the breast. AJR Am J Roentgenol 2003; 180: 347–51.
  • White RR, Halperin TJ, Olson JA Jr, Soo MS, Bentley RC, Seigler HF. Impact of core-needle breast biopsy on the surgical management of mammographic abnormalities. Ann Surg 2001; 233: 769–77.
Toplam 19 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma makaleleri
Yazarlar

Mehmet Soytürk 0000-0002-9011-3660

Ruhullah Eşim Bu kişi benim 0000-0002-0718-4071

Ahmet Yalçın 0000-0002-9708-0988

İlyas Sayar 0000-0002-7204-4112

Ali Küpeli 0000-0002-5322-2972

Yayımlanma Tarihi 1 Aralık 2019
Yayımlandığı Sayı Yıl 2019

Kaynak Göster

Vancouver Soytürk M, Eşim R, Yalçın A, Sayar İ, Küpeli A. BIRADS III meme lezyonlarına ultrasonografi eşliğinde yapılan biyopsilerde radyolojik patolojik korelasyon. otd. 2019;11(4):409-14.

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