Sonographic Visibility and Feasibility of Biopsy under Ultrasound Guidance of Suspicious Microcalcification-only Breast Lesions: a Single-centre Study
TE Kim, DB Kim, JH Jung, EK Lee
Hong Kong J Radiol 2015;18:125-33
DOI: 10.12809/hkjr1514264
Objectives: To assess the sonographic visibility and feasibility of biopsy under ultrasound guidance of mammographically suspicious microcalcification-only lesions.
Methods: A retrospective review was performed of mammographically detected suspicious microcalcification-only lesions in patients who underwent ultrasound-guided or surgical biopsy between March 2009 and February 2012. The identified microcalcifications were not associated with a mass, architectural distortion or asymmetry on mammography; or a mass, dilated duct, hypoechoic area or microcyst on ultrasound. Microcalcifications were divided into two groups of visible and invisible based on their sonographic visibility. An ultrasound-guided biopsy was performed for the visible group, and mammography-guided localisation and excisional biopsy were conducted for the invisible group. To confirm microcalcification retrieval, radiographs were obtained for all patients. The histological outcomes of the two groups were assessed.
Results: Of the 45 lesions in 44 patients, 22 (48.9%) were in the visible group. Calcifications were retrieved from 21 (95.5%) of the visible group lesions. The malignancy rate was 50.0% (11 of 22; p = 0.029) in the visible group and 17.4% (4 of 23) in the invisible group. Among the 10 sonographically visible and one invisible lesion that underwent surgical excision after biopsy, three (30.0%) in the visible group were upgraded pathologically.
Conclusion: The sonographic visibility and retrieval rates of microcalcification-only lesions were 48.9% and 95.5%, respectively. Among the suspicious microcalcification-only lesions, sonographically visible microcalcifications were more likely to be malignant than sonographically invisible microcalcifications.
中文摘要
乳腺單純微鈣化疑似病變的超聲能見度和超聲引導下穿刺活檢的可行性：一項單中心研究
TE Kim, DB Kim, JH Jung, EK Lee
目的：評估乳腺X線鉬靶片上疑似單純微鈣化病灶的超聲能見度和超聲引導下穿刺活檢的可行性。
方法：回顧分析2009年3月至2012年2月期間因乳腺鉬靶片上疑似單純微鈣化病變而接受超聲引導下穿刺活檢或手術下活檢的病人。經確診的微鈣化與乳腺X線攝影發現的腫塊、結構紊亂或局灶性不對稱無關；超聲發現的腫塊、擴張導管、低迴聲區或微囊腫也無關。微鈣化在超聲下可分為可見和不可見兩組。可見組病例進行超聲引導下穿刺活檢；對不可見組病例則進行乳腺X線攝影引導定位和病灶切除活檢。獲取所有患者乳腺X線片以確認微鈣化的檢出，並評估兩組的組織學結果。
結果：44名患者的45例病變中，22例（48.9%）納入超聲下可見組，其中21例（95.5%）檢出微鈣化。超聲下可見和不可見兩組的惡性腫瘤比率分別為50.0%（22例中的11例；p = 0.029）和17.4%（23例中的4例）。10例超聲可見和1例超聲不可見的患者在活檢後進行手術切除，超聲可見組中3例（30.0%）病理級別升高。
結論：乳腺單純微鈣化病變的超聲可見度為48.9%，檢出率為95.5%。在疑似單純微鈣化的乳腺病灶中，超聲可見的比超聲不可見的有較高機會屬於惡性病變。