Sclerosing Adenosis: Should We Still Regard It as a Simple Benign Disease? Report of Two Patients with Subsequent Development of Invasive or In-situ Breast Cancer
HN Wong, H Tsunoda, N Matsuda, K Suzuki, CP Li, EWS Fok, JLF Chiu, SCH Chan
Hong Kong J Radiol 2014;17:49-56
DOI: 10.12809/hkjr1412151
Sclerosing adenosis belongs to the group of benign proliferative breast diseases. The imaging and histological findings of sclerosing adenosis can mimic invasive ductal carcinoma. The diagnosis of sclerosing adenosis is challenging, and requires the combination of clinical, radiological, and pathological findings. Sclerosing adenosis is associated with a small risk of subsequent breast carcinoma. This report is of two patients with incidentally detected and biopsy-proven sclerosing adenosis. The clinical history, serial mammogram, breast ultrasonography, and preoperative breast magnetic resonance imaging findings are reviewed and the histological slides of the biopsy and surgical specimens are presented. In both patients, serial follow-up ultrasonography 7 years after the initial diagnosis showed mild increase in vascularity in the lesions. Repeat biopsies were performed, which showed invasive ductal carcinoma and ductal carcinoma in situ in patient 1 and patient 2, respectively. The authors recommend long-term follow-up for a sclerosing adenosis because of the risk of breast carcinoma with a long latency period. If any suspicious feature or change in morphology is detected in follow-up imaging, a biopsy should be performed to exclude carcinoma.
中文摘要
硬化性腺病：是否依然視作單純良性病變？兩名硬化性腺病患者後期發展為侵襲性或原位乳腺癌的報告
王馨藝、角田博子、松田直子、鈴木高佑、李治平、霍泳珊、趙朗峰、陳慈欽
硬化性腺病屬於良性乳腺增生病變，其影像和組織學檢查結果與浸潤性導管癌相似。硬化性腺病的診斷具挑戰性，須結合臨床、影像學和病理結果。硬化性腺病與未來發展成乳腺癌的風險有少許相關。本文報告兩名意外發現並獲活檢證實的硬化性腺病病例。回顧病人的臨床病史、乳腺X光檢查、乳腺超聲檢查和術前乳腺磁共振成像的結果並展示活檢的組織切片和手術標本。兩名病人於首次診斷硬化性腺病後連續超聲隨訪，七年後發現病灶有輕微的血流增加。重複進行活檢發現兩名患者分別有浸潤性導管癌和導管原位癌。由於乳腺癌有很長的潛伏期，我們建議為硬化性腺病患者進行長期隨訪。如果隨訪影像發現有任何可疑的徵狀或形態學上的變化，便應替病人進行活檢以排除癌症的可能性。