在核心针活检中发现的放射性硬化病变:切除可以安全地避免
Anne Grabenstetter1, Sandra B Brennan2, Maxine S Jochelson2
1Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Histopathology
|June 7, 2024
概括
观察是放射性硬化性病变 (RSL) 的安全方法,没有异型. 手术切除很少会显示出侵袭性癌症或局部导管癌 (DCIS) 的升级,这表明常规手术不必要.
科学领域:
- 乳腺病理学 乳腺病理学
- 手术瘤学手术瘤学
- 放射学 放射学是一门学科.
背景情况:
- 放射性硬化性病变 (RSL) 是良性乳腺病变,可以在成像上模仿恶性病变.
- 通过核心活检诊断的RSL的治疗方法,特别是关于外科切除的治疗方法,也在讨论中.
研究的目的:
- 在核心活检后,评估RSL在没有异型症的情况下升级到恶性瘤 (侵入性癌症或DCIS) 的速度.
- 为临床决策提供有关RSL外科切除必要性的信息.
主要方法:
- 在2015-2021年期间,对130个被诊断为RSL而没有异型的核心活检进行了回顾性审查.
- 活检诊断的确认和图像检查的审查,以检查放射病理一致性.
- 对随后的手术切除样本进行分析,以检测任何恶性瘤的升级.
主要成果:
- 在130例 (1.5%) 中,只有2例呈现恶性瘤的升级 (微侵袭性叶状癌和具有DCIS的侵袭性乳腺癌).
- 升级是偶然的,与活检部位没有密切关联.
- 研究中124名女性的平均年龄为52岁,病变的大小各不相同,通过乳房影像,MRI或超声波检测到.
结论:
- 这项研究支持观察作为一个可行的RSL没有异型的管理策略.
- 没有异型性RSL的例行手术切除可能不需要,减少过度治疗.
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