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首页> 外文期刊>European Journal of Inflammation >Underestimation of Atypical Lobular Hyperplasia and Lobular Carcinoma in Situ at Stereotaxic 11-Gauge Vacuum-Assisted Breast Biopsy:
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Underestimation of Atypical Lobular Hyperplasia and Lobular Carcinoma in Situ at Stereotaxic 11-Gauge Vacuum-Assisted Breast Biopsy:

机译：立体定位的11号真空辅助乳腺活检低估了非典型小叶增生和小叶原位癌：

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The aims of this study are to determine the frequency of diagnosis of atypical lobular hyperplasia (ALH) and lobular carcinoma in situ (LCIS) at stereotaxic-guided 11-gauge vacuum-assisted breast biopsy (VABB) and to assess the rate of underestimation of these at subsequent surgical excision and follow-up. Moreover, we aimed to define clinical, radiological and histological features of nonpalpable lesions in core biopsies that predict the lesion upgrade. Retrospective review of 11-gauge VABB was performed to identify the underestimation rate of nonpalpable lesions diagnosed as ALH or LCIS at VABB. Thirteen cases of ALH and 36 cases of LCIS were sent to surgery, 29 cases of ALH and 14 cases of LCIS were sent to follow-up. The clinical, mammographic and histologic features were assessed. The correlation between mammographic BI-RADS score and histological B-classification for both ALH and LCIS lesions were performed by Pearson's test. Of 1,765 patients enrolled, lobular lesions (ALH and/or LCIS) occurred in 82 cases, and underestimation arose in 9 (10.9%). Two cases of underestimated ALH were upgraded to invasive lobular carcinoma and one to invasive ductal carcinoma. One case of underestimated LCIS was upgraded to ductal carcinoma in situ, two to invasive ductal carcinoma and three to invasive lobular carcinoma. The histology of the core and surgical specimens were compared. A significant difference was seen in the BI-RADS score (4–5 in 91% of underestimated lesions), and the size of the lesions (≥ 1.5 cm) for underestimated cases versus accurately diagnosed cases (p0.001). Further significant parameters predictive for malignancy were the incomplete lesion removal by VABB and the presence of associated different breast lesions in the specimen. In conclusion, as far as ALH is concerned, we propose surgery as first choice when at least one of the following condition is respected: positive history for breast carcinoma, lesion 1.5cm, co-presence of high-risk lesions in the sample, signs of ductal involvement, high histological grading for atypia and follow-up in the other cases. Surgery is recommended in all cases of LCIS:.
机译：这项研究的目的是确定在立体定向引导的11号真空辅助乳腺活检（VABB）的诊断中非典型小叶增生（ALH）和小叶原位癌（LCIS）的频率，并评估低估率这些在随后的手术切除和随访中进行。此外，我们旨在定义核心活检中不可触及病变的临床，影像学和组织学特征，以预测病变升级。进行11规格VABB的回顾性研究，以确定在VABB上被诊断为ALH或LCIS的不可触及病变的低估率。 13例ALH和36例LCIS被送去手术，29例ALH和14例LCIS被送去随访。评估临床，乳腺X线摄影和组织学特征。通过皮尔逊检验，对ALH和LCIS病变的乳腺钼靶BI-RADS评分与组织学B分类之间的相关性进行了分析。在入组的1765名患者中，有82例发生了小叶病变（ALH和/或LCIS），其中9例（10.9％）被低估。 2例被低估的ALH升级为浸润性小叶癌，1例转化为浸润性导管癌。一例被低估的LCIS升级为原位导管癌，二例升级为浸润性导管癌，三例升级为浸润性小叶癌。比较了核心和手术标本的组织学。与低估病例相比，BI-RADS评分（低估病灶中91％的病灶为4–5）和病灶大小（≥1.5 cm）有明显差异（p <0.001）。预测恶性程度的其他重要参数是VABB清除病灶不完全以及标本中存在相关的不同乳腺病灶。总而言之，就ALH而言，当考虑到以下至少一种情况时，我们建议手术作为首选：乳腺癌阳性史，病变> 1.5cm，样品中高危病变并存，导管受累的迹象，非典型性的高组织学分级以及其他情况下的随访。建议在所有LCIS情况下进行手术：

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