Hypoechoic non-mass-like lesion on screening breast ultrasound : 이지현

다국어 초록 (Multilingual Abstract)

PURPOSE: The purpose of this study was to determine the significance of a hypoechoic non-mass-like lesion (HNML) which is recognized during screening breast ultrasound (US).
MATERIALS AND METHODS: Patients with a HNML on screening breast US and no suspicious finding on mammography between March 2008 and June 2012 were included. The final diagnoses were based on pathology results and a clinical or sonographic follow-up for more than 12 months. We calculated the incidence of HNML, likelihood of malignancy, and positive predictive value (PPV) of biopsy with a review of imaging and histopathological findings.
RESULTS: A total of 17868 screening breast US were performed in 8856 asymptomatic patients. Ninety-five HNMLs were detected in 88 patients (1.0%). Among the 93 lesions that were followed or confirmed pathologically, 2 (2.2%) were malignant, 89 (95.6%) were benign, and 2 (2.2%) were high risk lesions. The likelihood of malignancy in a HNML on screening breast US was 2.2% and the PPV of biopsy was 6.3% (2 of 32).
CONCLUSION: The likelihood of malignancy for a HNML on screening breast US was greater than 2%. It could be classified as a BI-RADS category 4a lesion and tissue diagnosis is warranted. This provides the potential management guidelines for a HNML in screening patients and further prospective studies in a large, multicenter screening population are needed.

국문 초록 (Abstract)

목적: 본 연구는 검진유방초음파에서 발견되는 저에코 비종괴영상형성병변의 의의를 알아보고자 하였다.

대상과 방법: 2008년 3월부터 2012년 6월까지 본원에서 시행한 검진유방초음파에서 발견된 저에코 비종괴영상형성병변을 가진 환자를 후향적으로 분석하였다. 최종진단은 병리결과나 일년이상의 임상 혹은 초음파 추적관찰로 판단하였다. 이를 통해 저에코 비종괴영상형성병변의 빈도, 악성도, 조직검사의 양성예측도를 계산하였다.

결과: 8856명의 무증상환자에서 17868명의 검진유방초음파가 행해졌고, 88명의 환자에서 95개의 저에코 비종괴영상형성병변이 관찰되었다 (1.0%). 최종진단된 93개의 병변 중 89개는 양성 (95.6%), 2개는 고위험도 (2.2%), 2개는 악성(2.2%) 이었다. 저에코 비종괴영상형성병변의 악성도는 2.2%이고 조직검사의 양성예측도는 6.3%였다 (2/32).

결론: 검진유방초음파에서 저에코 비종괴영상형성병변의 악성도는 2%이상으로 BI-RADS 분류 4a로서 조직학적 진단이 필요하다. 이 연구는 검진초음파에서 저에코 비종괴영상형성병변의 잠재적인 관리지침을 제공하는 것으로서, 대규모 다기관에서 연구가 필요할 것으로 보인다.

목차 (Table of Contents)

• I. Introduction 1
• II. Materials and methods 3
• 1. Patients selection and inclusion criteria 3
• 2. Image analysis 4
• 3. Establishment of the final diagnosis 5
• III. Results 6
• IV. Discussion 8
• Reference 19