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Memenin Fibroepitelyal Lezyonlarının US Bulgularının Eksizyonel Biyopsi Sonuçlarıyla Karşılaştırılması

Yıl 2021, Cilt: 47 Sayı: 1, 105 - 110, 01.04.2021
https://doi.org/10.32708/uutfd.844265

Öz

Çalışmamızın amacı, ultrasonografi (US) eşliğinde kesici iğne biyopsi (KİB) sonucu fibroepitelyal lezyon (FEL) olan lezyonların klinik ve US bulgularını, patolojik ayrımda kullanılan Ki-67 indeksini, eksizyonel biyopsi sonuçlarıyla karşılaştırarak ayırımda yararlı olabilecek bulguların araştırılmasıdır. 2009-2013 yılları arasında US eşliğinde KİB yapılmış 50 olguda, sonucu FEL olan 53 lezyon değerlendirilmiştir. Elliüç lezyonun 43’ü histopatolojik olarak FA, 10 tanesi de filloides tümör (FT) tanısı almıştır. Hastaların klinik bulguları, lezyonların BIRADS sınıflamasına göre yapılan ultrasonografik özellikleri ve KİB preparatlarının Ki-67 proliferatif indeks değerleri belirlenmiştir. Ayrıca meme radyolojisi konusunda 20 yıllık deneyim olan bir radyolog, eksizyon sonuçlarını bilmeden, lezyonların sonografik görüntülerini yorumlamıştır. Buna göre hiçbir klinik ve ultrasonografik parametrenin FA ve FT ayrımında özgün olmadığı sonucuna ulaşılmıştır. KİB preparatlarından yapılan Ki-67 proliferatif indeks değerleri de ayırıcı tanıya katkı sağlamamıştır. Ancak meme radyolojisi konusunda uzman radyoloğun öngörüsü ile cerrahi sonuçlar arasında istatistiksel olarak anlamlı uyumluluk bulunmuştur. Bu nedenle KİB sonucu FEL gelen ancak uzman radyoloğun benign olarak yorumladığı seçilmiş olgularda yakın takip alternatif bir seçenek olarak değerlendirilebilir.

Kaynakça

  • 1. Foster ME, Garrahan N, Williams S. Fibroadenoma of the breast: a clinical and pathological study. J R Coll Surg Edinb 1998;33:16–19.
  • 2. http://dspace.library.uu.nl/bitstream/handle/1874/10374/c2.pdf.
  • 3. Rosen PP. Rosen’s breast pathology, 2nd ed. Philadelphia, Pa: Lippincott Williams & Wilkins, 2001.
  • 4. Goel NB, Knight TE, Pandey S, Riddick-Young M, de Paredes ES, Trivedi A. Fibrous lesions of the breast: imaging-pathologic correlation. Radiographics. 2005 Nov-Dec;25(6):1547-59.
  • 5. Stavros AT, Cynthia L (eds). Breast Ultrasound. 4th edition. Philadelphia: Lippincott Williams and Wilkins; 2004. 157-85.
  • 6. Kocova L, Skalova A, Fakan F, Rousarova M. Phyllodes tumour of the breast: immunohistochemical study of 37 tumors using MIB1 antibody. Pathol Res Pract 1998;194:97–104.
  • 7. Jacobs TW, Chen YY, Guinee DG Jr, et al. Fibroepithelial lesions with cellular stroma on breast core needle biopsy: are there predictors of outcome on surgical excision? Am J Clin Pathol, 2005;124(3):342-54.
  • 8. Lee AHS, Hodi Z, Ellis IO, Elston CW. Histological features useful in the distinction of phyllodes tumour and fibroadenoma on needle core biopsy of the breast. Histopathology 2007; 51: 336-344.
  • 9. Bellocq JP, Magro G: Fibroepitelial Tumours. In Tavassoli FA, Devile P (Eds): Pathology and Genetics: Tumours of the Breast and Female Genital Tract. No:4. Lyon: IARC, 2003, 99-103.
  • 10. Hessler C, Schnyder P, Ozzello L. Hamartoma of tbc breast: Diagnostic observation of 16 cases. Radiology 1978;126:95-8.
  • 11. Bode MK, Rissanen T, Apaja-Sarkkinen M. Ultrasonography and core needle biopsy in the differential diagnosis of fibroade-noma and tumor phyllodes. Acta Radiol 2007;48(7):708-13.
  • 12. Ridgway PF, Jacklin RK, Ziprin P, et al. Perioperative diagno-sis of cystosarcoma phyllodes of the breast may be enhanced by MIB-1 index. J Surg Res 2004;122(1):83-8.
  • 13. Cohn-Cedermark G, Rutqvist LE, Rosendahl I, et al. Prognostic factors in cystosarcoma phyllodes. A clinicopathologic study of 77 patients. Cancer 1991;68:2017-22.
  • 14. Reinfuss M, Mitus J, Duda K, Stelmach A, Rys J, Smolak K. The treatment and prognosis of patients with phyllodes tumor of the breast: an analysis of 170 cases. Cancer 1996;77:910–6.
  • 15. Jacklin RK, Ridgway PF, Ziprin P, Healy V, Hadjiminas D, Darzi A. Optimising preoperative diagnosis in phyllodes tumour of the breast. J Clin Pathol 2006;59(5):454-9.
  • 16. Liberman L, Bonaccio E, Hamele-Bena D, Abramson AF, Cohen MA, Dershaw DD. Benign and malignant phyllodes tu-mors: mammographic and sonographic findings. Radiology 1996;198(1):121-4.
  • 17. Komenaka IK, El-Tamer M, Pile-Spellman E, Hibshoosh H. Core needle biopsy as a diagnostic tool to differentiate phyllo-des tumor from fibroadenoma. Arch Surg 2003;138(9):987-90.
  • 18. Foxcroft LM, Evans EB, Porter AJ. Difficulties in the pre-operative diagnosis of phyllodes tumours of the breast: a study of 84 cases. Breast 2007;16(1):27-37
  • 19. Resetkova E, Khazai L, Albarracin CT, Arribas E. Clinical and radiologic data and core needle biopsy findings should dictate management of cellular fibroepithelial tumors of the breast. Breast J 2010;16(6):573-80.
  • 20. Wiratkapun C, Piyapan P, Lertsithichai P, Larbcharoensub N. Fibroadenoma versus phyllodes tumor: distinguishing factors in patients diagnosed with fibroepithelial lesions after a core need-le biopsy. Diagn Interv Radiol. 2014 Jan-Feb;20(1):27-33. doi: 10.5152/dir.2013.13133.
  • 21. Buchberger W, Strasser K, Heim K, Müller E, Schröcksnadel H. Phylloides tumor: findings on mammography, sonography, and aspiration cytology in 10 cases. AJR Am J Roentgenol 1991;157(4):715-9.
  • 22. Liu J, Shu T, Chang S, Sun P, Zhu H, Li H. Risk of malignancy associated with a maternal family history of cancer. Asian Pac J Cancer Prev 2014;15(5):2039-44.
  • 23. Yilmaz E, Sal S, Lebe B. Differentiation of phyllodes tumors versus fibroadenomas. Acta Radiol 2002;43(1):34-9.
  • 24. Chao TC, Lo YF, Chen SC, et al. Sonographic features of phyllodes tumours of the breast. Ultrasound Obstet Gynecol 2002;20:64-71.
  • 25. Fornage BD, Lorigan JG, Andry E. Fibroadenoma of the breast: sonographic appearance. Radiology 1989;172(3):671-5.
  • 26. Swisher RC, Gade NR, Suk JJ, Fu YS, Bassett LW. Enlarging fibroadenoma in a postmenopausal woman: Case Report. Radi-ology 1992;184:425-6.
  • 27. Chao TC, Lo YF, Chen SC, Chen MF. Phyllodes tumors of the breast. Eur Radiol 2003;13(1):88-93.
  • 28. Harper AP, Kelly-Fry E, Noe JS, Bies JR, Jackson VP. Ultra-sound in the evaluation of solid breast masses. Radiology 1983;146:731-6.
  • 29. Yang X, Kandil D, Cosar EF, Khan A. Fibroepithelial tumors of the breast: pathologic and immunohistochemical features and molecular mechanisms. Arch Pathol Lab Med 2014;138(1):25-36.
  • 30. Umekita Y, Yoshida H. Immunohistochemical study of MIB1 expression in phyllodes tumour and fibroadenoma. Pathol Int 1999;49:807–10.
  • 31. Yonemori K, Hasegawa T, Shimizu C, Shibata T, Matsumoto K, Kouno T et al (2006) Correlation of p53 and MIB-1 expres-sion with both the systemic recurrence and survival in cases of phyllodes tumors of the breast. Pathol Res Pract 202(10):705–712.
  • 32. Chan YJ, Chen BF, Chang CL, Yang TL, Fan CC (2004) Expression of p53 protein and Ki-67 antigen in phyllodes tumor of the breast. J Chin Med Assoc 67(1):3–8.
  • 33. Harvey JA, Nicholson BT, Lorusso AP, Cohen MA, Bovbjerg VE. Short-term follow-up of palpable breast lesions with be-nign imaging features: evaluation of 375 lesions in 320 women. AJR Am J Roentgenol. 2009 Dec;193(6):1723-30. doi: 10.2214/AJR.09.2811. PMID: 19933671.

Comparison of Ultrasonographic Features of Fibroepitelial Lesions of the Breast with Excisional Biopsy Results

Yıl 2021, Cilt: 47 Sayı: 1, 105 - 110, 01.04.2021
https://doi.org/10.32708/uutfd.844265

Öz

In this study, we have retrospectively reviewed our archive between January 2009 and November 2013 for breast lesions that had a diagnosis of fibroepithelial lesion on core needle biopsy that underwent surgical excision. We have identified 53 FEL and retrospectively reviewed sonographic images based on BI-RADS lexicon. We have compared sonographic findings to Ki-67 indices and excisional biopsy results. Patient characteristics, presenting symptoms, clinical and physical examination findings and Ki-67 proliferation index of the core-needle biopsy spesimens were retrieved from patient archive. A radiologist with 20 years of experience in breast radiology, retrospectively tried to differentiate FA from PT based on sonographic images blind to the clinical and histopathological data. In accordance with the available literature, sonographic features based on BI-RADS classification and clinical features in our study were not able to discriminate between FA and PT. Additionally, Ki-67 staining of core needle biopsy specimens did not allow specific discrimination of FA from PT. Our study indicates that patients with a pathological diagnosis of FEL on core needle biopsy along with findings suggestive of benign features as identified by an expert radiologist can be managed conservatively with a close follow-up.

Kaynakça

  • 1. Foster ME, Garrahan N, Williams S. Fibroadenoma of the breast: a clinical and pathological study. J R Coll Surg Edinb 1998;33:16–19.
  • 2. http://dspace.library.uu.nl/bitstream/handle/1874/10374/c2.pdf.
  • 3. Rosen PP. Rosen’s breast pathology, 2nd ed. Philadelphia, Pa: Lippincott Williams & Wilkins, 2001.
  • 4. Goel NB, Knight TE, Pandey S, Riddick-Young M, de Paredes ES, Trivedi A. Fibrous lesions of the breast: imaging-pathologic correlation. Radiographics. 2005 Nov-Dec;25(6):1547-59.
  • 5. Stavros AT, Cynthia L (eds). Breast Ultrasound. 4th edition. Philadelphia: Lippincott Williams and Wilkins; 2004. 157-85.
  • 6. Kocova L, Skalova A, Fakan F, Rousarova M. Phyllodes tumour of the breast: immunohistochemical study of 37 tumors using MIB1 antibody. Pathol Res Pract 1998;194:97–104.
  • 7. Jacobs TW, Chen YY, Guinee DG Jr, et al. Fibroepithelial lesions with cellular stroma on breast core needle biopsy: are there predictors of outcome on surgical excision? Am J Clin Pathol, 2005;124(3):342-54.
  • 8. Lee AHS, Hodi Z, Ellis IO, Elston CW. Histological features useful in the distinction of phyllodes tumour and fibroadenoma on needle core biopsy of the breast. Histopathology 2007; 51: 336-344.
  • 9. Bellocq JP, Magro G: Fibroepitelial Tumours. In Tavassoli FA, Devile P (Eds): Pathology and Genetics: Tumours of the Breast and Female Genital Tract. No:4. Lyon: IARC, 2003, 99-103.
  • 10. Hessler C, Schnyder P, Ozzello L. Hamartoma of tbc breast: Diagnostic observation of 16 cases. Radiology 1978;126:95-8.
  • 11. Bode MK, Rissanen T, Apaja-Sarkkinen M. Ultrasonography and core needle biopsy in the differential diagnosis of fibroade-noma and tumor phyllodes. Acta Radiol 2007;48(7):708-13.
  • 12. Ridgway PF, Jacklin RK, Ziprin P, et al. Perioperative diagno-sis of cystosarcoma phyllodes of the breast may be enhanced by MIB-1 index. J Surg Res 2004;122(1):83-8.
  • 13. Cohn-Cedermark G, Rutqvist LE, Rosendahl I, et al. Prognostic factors in cystosarcoma phyllodes. A clinicopathologic study of 77 patients. Cancer 1991;68:2017-22.
  • 14. Reinfuss M, Mitus J, Duda K, Stelmach A, Rys J, Smolak K. The treatment and prognosis of patients with phyllodes tumor of the breast: an analysis of 170 cases. Cancer 1996;77:910–6.
  • 15. Jacklin RK, Ridgway PF, Ziprin P, Healy V, Hadjiminas D, Darzi A. Optimising preoperative diagnosis in phyllodes tumour of the breast. J Clin Pathol 2006;59(5):454-9.
  • 16. Liberman L, Bonaccio E, Hamele-Bena D, Abramson AF, Cohen MA, Dershaw DD. Benign and malignant phyllodes tu-mors: mammographic and sonographic findings. Radiology 1996;198(1):121-4.
  • 17. Komenaka IK, El-Tamer M, Pile-Spellman E, Hibshoosh H. Core needle biopsy as a diagnostic tool to differentiate phyllo-des tumor from fibroadenoma. Arch Surg 2003;138(9):987-90.
  • 18. Foxcroft LM, Evans EB, Porter AJ. Difficulties in the pre-operative diagnosis of phyllodes tumours of the breast: a study of 84 cases. Breast 2007;16(1):27-37
  • 19. Resetkova E, Khazai L, Albarracin CT, Arribas E. Clinical and radiologic data and core needle biopsy findings should dictate management of cellular fibroepithelial tumors of the breast. Breast J 2010;16(6):573-80.
  • 20. Wiratkapun C, Piyapan P, Lertsithichai P, Larbcharoensub N. Fibroadenoma versus phyllodes tumor: distinguishing factors in patients diagnosed with fibroepithelial lesions after a core need-le biopsy. Diagn Interv Radiol. 2014 Jan-Feb;20(1):27-33. doi: 10.5152/dir.2013.13133.
  • 21. Buchberger W, Strasser K, Heim K, Müller E, Schröcksnadel H. Phylloides tumor: findings on mammography, sonography, and aspiration cytology in 10 cases. AJR Am J Roentgenol 1991;157(4):715-9.
  • 22. Liu J, Shu T, Chang S, Sun P, Zhu H, Li H. Risk of malignancy associated with a maternal family history of cancer. Asian Pac J Cancer Prev 2014;15(5):2039-44.
  • 23. Yilmaz E, Sal S, Lebe B. Differentiation of phyllodes tumors versus fibroadenomas. Acta Radiol 2002;43(1):34-9.
  • 24. Chao TC, Lo YF, Chen SC, et al. Sonographic features of phyllodes tumours of the breast. Ultrasound Obstet Gynecol 2002;20:64-71.
  • 25. Fornage BD, Lorigan JG, Andry E. Fibroadenoma of the breast: sonographic appearance. Radiology 1989;172(3):671-5.
  • 26. Swisher RC, Gade NR, Suk JJ, Fu YS, Bassett LW. Enlarging fibroadenoma in a postmenopausal woman: Case Report. Radi-ology 1992;184:425-6.
  • 27. Chao TC, Lo YF, Chen SC, Chen MF. Phyllodes tumors of the breast. Eur Radiol 2003;13(1):88-93.
  • 28. Harper AP, Kelly-Fry E, Noe JS, Bies JR, Jackson VP. Ultra-sound in the evaluation of solid breast masses. Radiology 1983;146:731-6.
  • 29. Yang X, Kandil D, Cosar EF, Khan A. Fibroepithelial tumors of the breast: pathologic and immunohistochemical features and molecular mechanisms. Arch Pathol Lab Med 2014;138(1):25-36.
  • 30. Umekita Y, Yoshida H. Immunohistochemical study of MIB1 expression in phyllodes tumour and fibroadenoma. Pathol Int 1999;49:807–10.
  • 31. Yonemori K, Hasegawa T, Shimizu C, Shibata T, Matsumoto K, Kouno T et al (2006) Correlation of p53 and MIB-1 expres-sion with both the systemic recurrence and survival in cases of phyllodes tumors of the breast. Pathol Res Pract 202(10):705–712.
  • 32. Chan YJ, Chen BF, Chang CL, Yang TL, Fan CC (2004) Expression of p53 protein and Ki-67 antigen in phyllodes tumor of the breast. J Chin Med Assoc 67(1):3–8.
  • 33. Harvey JA, Nicholson BT, Lorusso AP, Cohen MA, Bovbjerg VE. Short-term follow-up of palpable breast lesions with be-nign imaging features: evaluation of 375 lesions in 320 women. AJR Am J Roentgenol. 2009 Dec;193(6):1723-30. doi: 10.2214/AJR.09.2811. PMID: 19933671.
Toplam 33 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Radyoloji ve Organ Görüntüleme
Bölüm Özgün Araştırma Makaleleri
Yazarlar

Başak Erdemli Gürsel 0000-0002-0047-1780

Sahsine Tolunay 0000-0002-9038-0515

Sedat Giray Kandemirli 0000-0002-3976-4062

Naile Bolca Topal 0000-0002-4821-242X

Dr. Öğr. Üyesi Mehmet Onur Kaya 0000-0001-8052-0484

Yayımlanma Tarihi 1 Nisan 2021
Kabul Tarihi 16 Nisan 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 47 Sayı: 1

Kaynak Göster

APA Erdemli Gürsel, B., Tolunay, S., Kandemirli, S. G., Bolca Topal, N., vd. (2021). Memenin Fibroepitelyal Lezyonlarının US Bulgularının Eksizyonel Biyopsi Sonuçlarıyla Karşılaştırılması. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 47(1), 105-110. https://doi.org/10.32708/uutfd.844265
AMA Erdemli Gürsel B, Tolunay S, Kandemirli SG, Bolca Topal N, Kaya DÖÜMO. Memenin Fibroepitelyal Lezyonlarının US Bulgularının Eksizyonel Biyopsi Sonuçlarıyla Karşılaştırılması. Uludağ Tıp Derg. Nisan 2021;47(1):105-110. doi:10.32708/uutfd.844265
Chicago Erdemli Gürsel, Başak, Sahsine Tolunay, Sedat Giray Kandemirli, Naile Bolca Topal, ve Dr. Öğr. Üyesi Mehmet Onur Kaya. “Memenin Fibroepitelyal Lezyonlarının US Bulgularının Eksizyonel Biyopsi Sonuçlarıyla Karşılaştırılması”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 47, sy. 1 (Nisan 2021): 105-10. https://doi.org/10.32708/uutfd.844265.
EndNote Erdemli Gürsel B, Tolunay S, Kandemirli SG, Bolca Topal N, Kaya DÖÜMO (01 Nisan 2021) Memenin Fibroepitelyal Lezyonlarının US Bulgularının Eksizyonel Biyopsi Sonuçlarıyla Karşılaştırılması. Uludağ Üniversitesi Tıp Fakültesi Dergisi 47 1 105–110.
IEEE B. Erdemli Gürsel, S. Tolunay, S. G. Kandemirli, N. Bolca Topal, ve D. Ö. Ü. M. O. Kaya, “Memenin Fibroepitelyal Lezyonlarının US Bulgularının Eksizyonel Biyopsi Sonuçlarıyla Karşılaştırılması”, Uludağ Tıp Derg, c. 47, sy. 1, ss. 105–110, 2021, doi: 10.32708/uutfd.844265.
ISNAD Erdemli Gürsel, Başak vd. “Memenin Fibroepitelyal Lezyonlarının US Bulgularının Eksizyonel Biyopsi Sonuçlarıyla Karşılaştırılması”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 47/1 (Nisan 2021), 105-110. https://doi.org/10.32708/uutfd.844265.
JAMA Erdemli Gürsel B, Tolunay S, Kandemirli SG, Bolca Topal N, Kaya DÖÜMO. Memenin Fibroepitelyal Lezyonlarının US Bulgularının Eksizyonel Biyopsi Sonuçlarıyla Karşılaştırılması. Uludağ Tıp Derg. 2021;47:105–110.
MLA Erdemli Gürsel, Başak vd. “Memenin Fibroepitelyal Lezyonlarının US Bulgularının Eksizyonel Biyopsi Sonuçlarıyla Karşılaştırılması”. Uludağ Üniversitesi Tıp Fakültesi Dergisi, c. 47, sy. 1, 2021, ss. 105-10, doi:10.32708/uutfd.844265.
Vancouver Erdemli Gürsel B, Tolunay S, Kandemirli SG, Bolca Topal N, Kaya DÖÜMO. Memenin Fibroepitelyal Lezyonlarının US Bulgularının Eksizyonel Biyopsi Sonuçlarıyla Karşılaştırılması. Uludağ Tıp Derg. 2021;47(1):105-10.

ISSN: 1300-414X, e-ISSN: 2645-9027

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