进行乳腺磁共振成像治疗侵袭性叶状腺癌是否值得?
Zebadiah Melvin1, David Lim2, Angela Jacques3,4
1Diagnostic Imaging, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
ANZ journal of surgery
|July 1, 2024
概括
对侵袭性叶状癌 (ILC) 的乳腺MRI分期检测到近一半的患者有额外的重大病变,主要是ipsilateral多焦点性疾病. 这种方法有助于手术规划,而不会大大延迟最终的治疗.
科学领域:
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
- 乳房成像 乳房成像
背景情况:
- 侵袭性叶状腺癌 (ILC) 的分期在乳房影像和超声波方面具有挑战性,导致潜在的诊断不足和不利的患者结果.
- 常规分期乳房MRI在我们的机构中被用来提高ILC分期的准确性.
- 人们担心患者焦虑增加和治疗延迟,原因是MRI引发的进一步成像和活检.
研究的目的:
- 量化通过ILC患者的MRI分期检测到的额外病变的频率.
- 为了确定增加的癌症检测率的分期MRI.
- 评估MRI对手术管理决策的影响.
主要方法:
- 从2019年1月到2022年8月,对110名新诊断的ILC患者进行了一项观察性研究.
- 使用了标准化的3TMRI协议,研究经过双重阅读,由受过奖学金培训的放射科医生进行.
- 组织病理学作为评估MRI检测病变的参考标准.
主要成果:
- 45%的患者 (49/110) 至少有一个额外的临床显著的MRI检测到的病变.
- 31个 (58%) 额外的两侧病变中有18个是恶性病变,包括多焦点和多中心的ILC.
- 在11例 (10%) 的病例中,MRI改变了手术计划,将乳房保护手术改为乳房切除手术,并诊断出两种逆侧癌症.
结论:
- 阶段性乳腺MRI对ILC有效地识别了大量患者的临床显著的额外病变.
- 主要发现的是ipsilateral多焦点疾病,这会影响手术规划.
- 阶段性MRI可以在没有显著延迟到最终的手术管理的情况下进行.
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