Title Usporedba radiološkog i patohistološkog nalaza mikrokalcifikata na mamografiji Title (english) Comparison between radiological and patohistological findings of microcalcification on mammography Author Porin Šantek Mentor Maja Prutki (mentor)Committee member Gordana Ivanac (predsjednik povjerenstva)Committee member Milan Radoš (član povjerenstva)Committee member Maja Prutki (član povjerenstva)Granter University of Zagreb Defense date and country 2019-07-12, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Grupirana nakupina sumnjivih mikrokalcifikata na mamografiji je karakterističan nalaz ranog stadija karcinoma dojke, odnosno duktalnog karcinoma in situ.
U ovom istraživanju je analizirana metoda vakuum asistirane biopsije dojke pod kontrolom digitalne tomosinteze (DBT-VABB).
U retrospektivno istraživanje uključeno je 86 bolesnica (medijan životne dobi od 60 godina (raspon 40-81 godina)) koje su imale sumnjive nakupine kalcifikacija ili distorzije arhitektonike i kod kojih je učinjena vakuumom asistirana biopsija pod kontrolom digitalne tomosinteze na Kliničkom zavodu za dijagnostičku i intervencijsku radiologiju Kliničkog bolničkog centra Zagreb. Analizirana je točnost i dijagnostička vrijednost DBT-VABB-a u odnosu na patohistološki nalaz.
84 (97.7%) bolesnica je imalo mamografski detektirane sumnjive kalcifikacije, a dvije (2.3%) bolesnice arhitektonske distorzije. Fine pleomorfne kalcifikacije otkrivene su u 40 (47.6%) bolesnica, amorfne u 16 (19.0%), okrugle grupirane u 13 (15.5%), linearne ili razgranate linearne u 10 (11.9%), grube heterogene u 4 (4.8%) i okrugle u jedne (1.2%) bolesnice s mamografski detektiranih sumnjivim kalcifikacijama. Distribucija mikrokalcifikata je bila grupirana u 49 (58.3%), segmentalna u 22 (26.2%), regionalna u 7 (8.3%), te linearna u 6 (7.1%) bolesnica s mamografski detektiranim sumnjivim kalcifikacijama.
Patohistološka analiza uzoraka dobivenih DBT-VABB-om je pokazala 62 (72.1%) benigne promjene, 8 (9.3%) lezija nesigurnog malignog potencijala, 1 (1.2%) suspektnih malignih promjena i 15 (17.4%) malignih lezija. Od 15 malignih lezija, 7 (8.1%) je bilo in situ duktalnih karcinom i 8 (9.3%) invazivnih duktalnih karcinoma. Promjena u invazivni karcinom nakon kirurškog zahvata zabilježena je u 3 (37.5%) bolesnice s lezijama nesigurnog malignog potencijala i kod jedne bolesnice sa suspektnom malignom promjenom.
Dijagnostička točnost DBT-VABB-a bila je 95,6%, osjetljivost 78,9%, specifičnost 100%, pozitivna prediktivna vrijednost 100%, negativna prediktivna vrijednost 94.4% u analiziranoj skupini bolesnica.
DBT-VABB je brza, točna i minimalno invazivna procedura za mikrokalcifikacije i arhitektonske distorzije. Kod nalaza lezije granično malignog potencijala trebalo bi učiniti kiruršku biopsiju radi konačne patohistološke analize.
Abstract (english) Clustered suspicious microcalcifications can be a very early sign of malignancy, particularly typical for ductal carcinoma in situ.
This study analysed the vacuum-assisted biopsy method under the guidance of digital tomosynthesis (DBT-VABB).
The retrospective study included 86 patients (median age of 60 years (range 40-81 years)) that had suspicious clusters of calcification or architectural distortion and in whom a vacuum-assisted biopsy under the control of digital tomosynthesis was performed at the Department of Diagnostic and Interventional Radiology, University Hospital Center Zagreb. The accuracy and diagnostic value of DBT-VABB were analysed with the pathological findings.
84 (97.7%) patients had suspicious calcifications detected by mammography, and two (2.3%) patients had architectural distortion. Fine pleomorphic calcifications were detected in 40 (47.6%) patients, amorphous in 16 (19.0%), round grouped in 13 (15.5%), linear or branched linear in 10 (11.9%), rough heterogeneous in 4 (4.8%) and round in one (1.2%) patient with mammography-detected suspicious calcifications. Distribution of microcalcifications was grouped in 49 (58.3%), segmental in 22 (26.2%), regional in 7 (8.3%), and linear in 6 (7.1%) patients with mammography-detected suspicious calcifications.
Histopathologic analysis obtained by DBT-VABB showed 62 (72.1%) benign, 8 (9.3%) lesions of uncertain malignant potential, 1 (1.2%) lesion with suspected malignant changes and 15 (17.4%) malignant lesions. Of the 15 malignant lesions, 7 (8.1%) were in situ ductal carcinomas, and 8 (9.3%) were invasive ductal cancers. Post-surgical development to invasive cancer was observed in 3 (37%) patients with lesions of uncertain malignant potential, and one patient with a suspected malignant lesion.
Diagnostic accuracy of DBT-VABB was 95.6%, sensitivity 78.9%, specificity 100%, positive predictive value 100%, negative predictive value 94.4% in the analyzed group of patients.
DBT-VABB is a fast, accurate and minimally invasive procedure for microcalcification and architectural distortion. Lesions of uncertain malignant potential should undergo a surgical biopsy to obtain a final histological result.
Keywords
vakuum asistirana biopsija
digitalna tomosinteza dojke
karcinom dojke
mikrokalcifikati
Keywords (english)
vacuum-assisted biopsy
digital breast tomosynthesis
breast carcinoma
microcalcifications
Language croatian URN:NBN urn:nbn:hr:105:636263 Study programme Title: Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2020-03-11 15:43:25
