DBT假阴性乳腺癌临床、影像学和病理学特征分析  

Clinical,imaging and pathological features of DBT false-negative breast cancer

作　　者：罗冉[1] 王丽君[1] 汪登斌[1] LUO Ran;WANG Lijun;WANG Dengbin(Department of Radiology,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院放射科,上海2000092

出　　处：《肿瘤影像学》2022年第5期531-535,共5页Oncoradiology

基　　金：上海市卫生和计划生育委员会青年专项(2018Y40030);上海市“科技创新行动计划”产学研医合作领域项目(19DZ1930504);上海市科学技术委员会项目(21S31905000)。

摘　　要：目的:探究数字乳腺体层合成(digital breast tomosynthesis,DBT)假阴性乳腺癌临床、影像学和病理学特征,以避免漏诊。方法:回顾并收集2018年7月—2020年10月于上海交通大学医学院附属新华医院经病理学检查证实为乳腺癌、术前行诊断性DBT检查且判定为乳腺影像报告和数据系统(Breast Imaging Reporting and Data System,BI-RADS)1、2或3类的患者的资料,由2名经验丰富的乳腺影像专科医师进行回顾性阅片,分析其临床、影像学和病理学特征。结果:378例患者中31例患者共32个病灶DBT诊断为假阴性(8.2%),中位大小0.8(1.0)cm、不超过1 cm的病灶22个占68.8%。其中2个病灶未摄入,6个病灶分类错误,24个病灶在DBT不可见;术前超声阳性率56.25%(18/32),术前磁共振成像(magnetic resonance imaging,MRI)阳性率100.00%(32/32)。病理学类型包括乳腺导管原位癌(ductal carcinoma in situ of the breast,DCIS)14个(43.75%),乳头状癌8个(25.00%)和浸润癌10个(31.25%)。结论:DBT假阴性乳腺癌并不罕见,大多腺体较丰富、病灶较小,可以是DCIS或浸润癌,结合超声、MRI检查有助于减少漏诊。Objective:To explore the clinical,imaging,and pathological features of breast cancer with false negative digital breast tomosynthesis(DBT)and to avoid missed cancer.Methods:The database was retrospectively reviewed to collect pathologically confirmed breast cancer from July 2018 to October 2020 in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,which underwent preoperative diagnostic DBT with a Breast Imaging Reporting and Data System(BI-RADS)1,2,or 3 diagnoses.Two experienced breast imaging specialists reviewed DBT images of these cases.Clinical,imaging and pathological features were collected.Results:A total of 31 cases with 32 cancer lesions of 378 cases were included in this study.Median size of these lesions was 0.8(1.0)cm,22 lesions no larger than 1 cm accounting for 68.8%.2 lesions were not covered in the field of view,6 lesions were incorrectly classified,and 24 lesions were not visible on DBT images.The positive rate of preoperative ultrasound and magnetic resonance imaging(MRI)was 56.25%(18/32)and 100.00%(32/32),respectively.Pathological types of these lesions include ductal carcinoma in situ of the breast(DCIS)14 lesions(43.75%),papillary carcinoma 8 lesions(25.00%),and invasive carcinoma 10 lesions(31.25%).Conclusion:DBT false-negative breast cancer is not uncommon.Most of these lesions are small,and occurred in relatively dense breasts,which can be DCIS or invasive cancer.Supplemental ultrasonography and MRI may help reduce missed diagnosis in DBT false-negative cases.

关 键 词：乳腺癌 数字乳腺体层合成 假阴性 

分 类 号：R737.9[医药卫生—肿瘤] R445.4[医药卫生—临床医学]