Radiološka obrada bolesnica s iscjetkom iz bradavice

master's thesis

• Title (english): Radiological imaging of patients with nipple discharge
• Author: Ana Tonklin
• Mentor: Maja Prutki (mentor)
• Committee member: Maja Hrabak Paar (predsjednik povjerenstva)
• Committee member: Gordana Ivanac (član povjerenstva)
• Committee member: Maja Prutki (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Radiology); Zagreb
• Defense date and country: 2020-07-17, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Radiology

Abstract

CILJ: Svrha ovog istraživanja je analizirati točnost i kliničku vrijednost digitalne tomosinteze dojke (DTD) u bolesnica s iscjetkom iz bradavice te ju usporediti s drugim radiološkim metodama (mamografijom, ultrazvukom (UZV) i magnetnom rezonancijom (MR)) koje se koriste u obradi iscjetka iz bradavice. ----- MATERIJALI I METODE: U retrospektivno istraživanje uključene su 53 bolesnice prosječne dobi 54 godine s iscjetkom iz bradavice. Svim pacijenticama je učinjena DTD te su rezultati uspoređeni s mamografijom, UZV-om i MR-om. Nalazi mamografije, DTD, UZV-a i MR-a su kategorizirani prema BI-RADS klasifikaciji, gdje su kategorije 1-2 negativne, a 3-5 pozitivne. Konačna dijagnoza kod pacijentica sa sumnjivim radiološkim nalazom postavljena je na osnovi patohistološkog (PHD) nalaza uzorka tkiva, dok je potvrda benignog radiološkog nalaza zahtijevala nepromijenjenost nalaza u dvogodišnjem praćenju. Izračunata je dijagnostička točnost mamografije, DTD-a, UZV-a i MR-a u detektiranju karcinoma dojke. ----- REZULTATI: Od 53 bolesnice s iscjetkom iz bradavice, konačna PHD analiza je pokazala 6 (11.3%) malignih lezija. Sve maligne lezije su otkrivene kod bolesnica s patološkim iscjetkom. DTD i MR pokazale su visoku osjetljivost (100%) i negativnu prediktivnu vrijednost (100%) u otkrivanju karcinoma dojke kod pacijentica s iscjetkom iz bradavice. DTD je odnosu na MR pokazala veću specifičnost (82.9% vs. 61.9%). Mamografija je otkrivanju karcinoma dojke imala osjetljivost 83.3%, a specifičnost 76.6%. Osjetljivost i specifičnost UZV-a u otkrivanju karcinoma dojke iznosile su 66.7% i 57.5%. ----- ZAKLJUČAK: DTD ima veću specifičnost, a jednaku osjetljivost i negativnu prediktivnu vrijednost kao MR. Iz tog razloga trebamo razmotriti primjenu DTD kao alternativnu metodu MR-u u procjeni pacijentica s iscjetkom iz bradavice.

Abstract (english)

OBJECTIVE: The purpose of this study was to analyze the accuracy and clinical value of digital breast tomosynthesis (DBT) in patients with nipple discharge and to compare it with other radiological methods (mammography, ultrasound (US) and magnetic resonance imaging (MR)) used in the treatment of nipple discharge. ----- METHODS AND MATERIALS: This retrospective study included 53 patients with nipple discharge with an average age of 54 years. All patients underwent DBT and the results were compared to mammography, ultrasound and MR. The findings of mammography, DBT, ultrasound and MR were categorized according to the BI-RADS classification, where categories 1-2 were considered negative and 3-5 positive. The final diagnosis for patients with a suspicious radiological finding was made on the basis of the pathohistological (PHD) results of the tissue sample, while confirmation of the benign radiological finding required unchanged results in the two-year follow-up. The diagnostic accuracy of mammography, DTD, ultrasound, and MR for the detection of breast cancer were calculated. ----- RESULTS: Out of 53 patients with nipple discharge, the final PHD analysis showed 6 (11.3%) malignant lesions. All malignant lesions were detected in patients with pathological discharge. DBT and MR showed high sensitivity (100%) and negative predictive value (100%) in the detection of breast cancer in patients with nipple discharge. DBT showed greater specificity compared to MR (82.9% vs. 61.9%). Mammography had a sensitivity of 83.3% and a specificity of 76.6% in detecting breast cancer. The sensitivity and specificity of ultrasound in the detection of breast cancer were 66.7% and 57.5%, respectively. ----- CONCLUSION: DTD has higher specificity, and the same sensitivity and negative predictive value as MR. For this reason, the use of DBT as an alternative method to MR in the assessment of patients with nipple discharge should be considered.

• Keywords: iscjedak iz bradavice; karcinom dojke; digitalna tomosinteza dojke
• Keywords (english): nipple discharge; breast cancer; digital breast tomosynthesis
• Language: croatian
• URN:NBN: urn:nbn:hr:105:774144
• 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: 2021-05-11 07:01:38