초음파 유도하 중심생검에서 진단된 유방의 유두상 병변에서 악성을 예측할 수 있는 임상-영상소견: 복합에코여부에 따른 고찰

Abstract

Purpose: To evaluate the clinical and sonographic findings predicting malignancy in papillary lesions of breast diagnosed at the US-guided core-needle biopsy, focusing on complex echogenicity. Materials and Methods: Retrospective review of our database was performed from January 2003 through January 2010, to identify patients with papillary lesion of breast diagnosed at the US guided core needle biopsy and performed consecutive surgical or US-guided vacuum assisted excision. We included 272 papillary lesions of breast in 251 women (mean age: 46.7± 10.0 years, mean size: 12.9 ± 11.1 mm). Of the 272 lesions, 260 (95.6%) had excised by surgery and 12 (4.4%) by US guided vacuum assisted excision. We evaluated clinical and sonographic factors predictive of malignancy. Results: 203 (74.6 %) were benign and 69 (25.4%) were malignant. Among the 203 benign lesions, 174 (85.7%) were benign papilloma, 29 (14.3%) were atypical papilloma and among the 69 malignant lesions, 44 (63.8%) were non-invasive papillary carcinoma and 25 (36.2%) were invasive papillary carcinoma. 153 (56.25%, 113 benign and 40 malignant) lesions did not show complex echogenicity and 119 (43.75%, 90 benign and 29 malignant) lesions showed complex echogenicity. Palpability (p = 0.019), lesion location (> 2 cm from nipple, p = 0.025) were factors correlated with malignancy in all papillary breast lesion. In 153 non-complex echoic papillary lesion, suspicious irregular shape (p = 0.037), larger diameter (p < 0.001) were more frequently detected in malignant lesion than benign lesion. However, there was no sonographic feature to predict malignancy among the papillary lesions showing complex echogenicity. Only the lesion location (> 2 cm from nipple, p = 0.027) was factor correlated with malignancy in papillary lesion showing complex echogenicity. Conclusion: The lesion size and irregular sonographic feature are predictive factors for malignancy in the papillary lesion without showing complex echogenicity. However, due to the lack of distinguishable sonographic feature except lesion location, we should pay attention to interpreting image feature of papillary lesion with showing complex echogenicity.