Dijagnostički i terapijski postupci kod lezija visokog rizika u dojci (B3)

master's thesis

• Title (english): Diagnosis and management of high-risk breast lesions (B3)
• Author: Valentina Bahnik
• Mentor: Gordana Ivanac (mentor)
• Committee member: Vinko Vidjak (predsjednik povjerenstva)
• Committee member: Milan Radoš (član povjerenstva)
• Committee member: Gordana Ivanac (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Radiology); Zagreb
• Defense date and country: 2019-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Radiology
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Oncology

Abstract

Lezije visokog malignog potencijala su biološki i klinički heterogena skupina neoplastičkih promjena koje imaju potencijal direktne progresije u invazivni karcinom dojke. Takve promjene u prvoj liniji uključuju atipičnu epitelnu hiperplaziju duktalnog i lobularnog podrijetla (ADH i ALH), ravnu epitelijalnu atipiju (FEA), duktalni i lobularni karcinom in situ (DCIS i LCIS), te još neke promjene. Svrha ranog otkrivanja te liječenja ovih promjena zapravo je prevencija razvoja invazivnog karcinoma dojke. Karcinom dojke najčešći je karcinom u žena te predstavlja velik javnozdravstveni problem. Zbog toga je od iznimne važnosti pravovremeno otkriti te liječiti one pacijentice koje imaju visok rizik za razvoj karcinoma dojke.
ADH moguća je preteča DCIS i low-grade invazivnih tumora dojke. Napredovanjem tehnologije i upotrebom igala šireg kalibra tijekom biopsije omogućeno je uzimanje i analiza tkiva većih dimenzija te na takav način lakše razlikovanje ADH od DCSI u uzorcima. ADH i ALH sadrže neke od karakteristika in situ karcinoma te nose povišen rizik za razvoj karcinoma dojke.
Ravna epitelijalna atipija (FEA) ubraja se u skupinu kolumnarnih staničnih promjena te bi trebala ni biti znakom mogućih pridruženih promjena dojke poput ADH, LIN, DCIS ili invazivnog tubularnog karcinoma.
DCIS najčešći je oblik neinvazivnog karcinoma dojke koji nastaje iz nastaje iz epitela terminalnih duktalno-lobularnih jedinica (TDLU). Smatra se da je DCIS visokog gradusa izravni preteča invazivnog karcinoma zbog svojih molekularnih i genetskih osobina. LCIS rijedak je oblik karcinoma koji može imati dvojaku ulogu, kao pokazatelj povećanog rizika od karcinoma u obje dojke, te kao izravni perkursor nekih vrsta raka dojke.
Cilj ovog rada je prikazati kompleksnost lezija visokog malignog potencijala dojke te dati pobliži uvid terapije ovih promjena. Također cilj je i podizanje svjesnosti liječnika o postojanju navedenih lezija te njihovoj važnosti u razvoju invazivnog karcinoma dojke.

Abstract (english)

High-risk breast lesions are biologically and clinically heterogeneous group of neoplastic changes that have potential for direct progression to invasive breast carcinoma. Such changes include atypical epithelial hyperplasia of ductal and lobular origin (ADH and ALH), flat epithelial atypia (FEA), ductal and lobular carcinoma in situ (DCIS and LCIS), and some other changes. The purpose of early detection and treatment of these changes is actually prevention for development of invasive breast carcinoma. Breast cancer is the most common cancer in women and is a major public health problem. Therefore, it is of utmost importance to detect and treat patients who have a high risk of developing breast cancer .
ADH is a possible forerunner to DCIS and low-invasive breast tumors. By advancing the technology and using broader caliber needles during the biopsy, it is possible to take and analyze larger tissue size and in such way distinguish ADH from DCSI. ADH and ALH contain some of the characteristics of in situ cancer and carry an increased risk for development of breast cancer.
A flat epithelial atypia (FEA) is a group of colonic cellular changes and should be a sign of possible associated breast changes such as ADH, LIN, DCIS or invasive tubular carcinomas.
DCIS is the most common form of non-invasive breast carcinoma which originates from epithelial terminal duct-lobular units (TDLU). DCIS is considered to be a direct precursor to invasive cancer due to its molecular and genetic traits. LCIS is a rare form of cancer that can play a dual role as an indicator of increased risk for cancer in both breasts and as a direct precursor of some types of breast cancer.
The aim of this paper was to demonstrate the complexity of high-risk breast lesions potential and to provide a closer insight into the therapy of these changes. One of the goals of this paper was to raise the physician's awareness about the existence of these lesions and their importance in the development of invasive breast cancer.

• Keywords: lezije visokog malignog potencijala; dojka; karcinom; rizik
• Keywords (english): high-risk breast lesions; breast; cancer; risk
• Language: croatian
• URN:NBN: urn:nbn:hr:105:940022
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-11-20 14:16:23