Sažetak
Uvod/Cilj. Ultrazvučnim pregledom može ne samo da se napravi razlika između cističnih i solidnih promena u tkivu dojke, kao što je bilo na početku njegove primene, već i da se napravi diferencijalna dijagnoza u smislu razlikovanja benignih od malignih promena. Cilj rada bio je procena uloge ultrazvuka u dijagnostici palpabilnih promena u dojci u skladu sa terminologijom Breast Imaging Reporting and Data Systems (BI-RADS) i korelacija kategorija BI-RADS 4 i BI-RADS 5 sa patohistološkim nalazom. Metode. Retrospektivna studija sprovedena je u grupi od 30 žena sa palpabilnim promenama u dojci, sa mamografskom kategorijom BI-RADS 0 i ultrazvučnim kategorijama BI-RADS 4 i 5. Sonografske kategorije su korelisane sa patohistološkim nalazom. Rezultati. Eksciziona biopsija 30 promena je pokazala: malignitet (56,7%), fibroadenom (26,7%), fibrocističnu displaziju sa ili bez atipije (10%), lipom (3,3%) i intramamarni limfni nodus (3,3%). Korelacija između BI-RADS kategorija i patohistološkog nalaza je dokazana (p < 0,05). Sve BI-RADS 5 promene bile su maligne, dok je u BI-RADS 4A kategoriji dominirao fibroadenom. Ukupno 53,8% svih benignih promena pronađene su kod žena starosti 49 godina ili mlađih u poređenju sa 35,3% malignih promena u ovoj grupi (p < 0,05). Zaključak. Upotreba ultrazvučne BI-RADS nomenklature poboljšala je klasifikaciju promena u dojci. U slučaju ultrazvučnih kategorija BI-RADS 4 (A, B, C) i BI-RADS 5 trebalo bi raditi biopsiju.
Ključne reči
Array
Array
Array
Array
Array
Array
Array
Array
Array
Array
Array
Array
Array
Array
Array
Array
Array
Array
Array
Reference
Milošević Z. Newspapers mammography in the diagnosis of breast cancer. In: Nešković-Konstantinović Z, Borojević N, Vučković-Dekić Lj, editors. Newspapers in the diagnosis and treatment of breast cancer. Belgrade: Akademija medicinskih nauka Srpskog lekarskog društva, Institut za onkologiju i radiologiju Srbije; 2008. p. 41−52. (Serbian)
Crystal P, Strano SD, Shcharynski S, Koretz MJ. Using sonography to screen women with mammographically dense breasts. AJR Am J Roentgenol 2003; 181(1): 177−82.
Pichler E. Ultrasound breast atlas: differential diagnosis and intervention techniques. Zagreb: Školska knjiga; 2005. (Croa-tian)
Levy L, Suissa M, Chiche JF, Teman G, Martin B. BIRADS ultrasonography. Eur J Radiol 2007; 61(2): 202−11.
Dobrosavljević A, Brković V, Vujković B, Milošević Z. Basic constitutional and reproductive parameters in optimalise application of mammography in the diagnosis of breast diseases. Medicinski podmladak 2004; 55: 61−3. (Serbian)
Milošević Z. Malignant tumors of the breast. In: Goldner B, Milošević Z, Jovanović T, editors. Mammography in the diagnosis of breast diseases. Belgrade: Velarta; 2001. p. 217−82. (Ser-bian)
Park CS, Lee JH, Yim HW, Kang BJ, Kim HS, Jung JI, et al. Ob-server Agreement Using the ACR Breast Imaging Reporting and Data System (BI-RADS)-Ultrasound, First Edition (2003). Korean J Radiol 2007; 8(5): 397−402.
Jovićević BA. Epidemiology and prevention of breast cancer. In: Nešković-Konstantinović Z, Borojević N, Vučković-Dekić Lj, editors. Newspapers in the diagnosis and treatment of breast cancer. 2nd ed. Belgrade: Akademija medicinskih nauka Srpskog lekarskog društva i Institut za onkologiju i radiologiju Srbije. 2008. p. 11−24. (Serbian)
American College of Radiology. ACR Breast Imaging Reporting and Data System, Breast Imaging Atlas. 4th ed. Reston, VA: American College of Radiology; 2003.
Stavros AT, Thickman D, Rapp CL, Dennis MA, Parker SH, Sisney GA. Solid breast nodules: use of sonography to distinguish between benign and malignant lesions. Radiology 1995; 196(1): 123−34.
Ko ES, Lee BH, Kim H, Noh W, Kim MS, Lee S. Triple-negative breast cancer: correlation between imaging and pathological findings. Eur Radiol 2009; 20(5): 1111−7.
Radisky ES, Radisky DC. Matrix metalloproteinase-induced epithelial-mesenchymal transition in breast cancer. J Mammary Gland Biol Neoplasia 2010; 15(2): 201−12.
Kinoshita T, Yashiro N, Yoshigi J, Ihara N, Fukuma E, Narita M. Inflammatory intramammary lymph node mimicking the malignant lesion in dynamic MRI: a case report. Clin Imaging 2002; 26(4): 258−62.
Tabár L, Duffy SW, Vitak B, Chen HH, Prevost TC. The natural history of breast carcinoma: what have we learned from screening. Cancer 1999; 86(3): 449−62.
Graf O, Helbich TH, Hopf G, Graf C, Sickles EA. Probably benign breast masses at US: is follow-up an acceptable alternative to biopsy. Radiology 2007; 244(1): 87−93.
Izumori A, Takebe K, Sato A. Ultrasound findings and histological features of ductal carcinoma in situ detected by ultrasound examination alone. Breast Cancer 2010; 17(2): 136−41.