Can We Predict Phyllodes Tumor among Fibroepithelial Lesions with Cellular Stroma Diagnosed at Breast Core Needle Biopsy?

유방의 중심부바늘생검에서 진단된 세포충실성섬유상피병변에서 엽상종양을 예측할 수 있는가?

  • Jung, Hae-Kyoung (Department of Radiology, CHA University College of Medicine) ;
  • Ko, Kyung-Hee (Department of Radiology, CHA University College of Medicine) ;
  • Rho, Ji-Young (Department of Radiology, CHA University College of Medicine) ;
  • Moon, Hee-Jung (Department of Radiology, Yonsei University College of Medicine) ;
  • Kim, Eun-Kyung (Department of Radiology, Yonsei University College of Medicine) ;
  • Kim, Min-Jung (Department of Radiology, Yonsei University College of Medicine) ;
  • Park, Byeong-Woo (Department of Radiology, Yonsei University College of Medicine)
  • 정혜경 (차의과대학교 영상의학과) ;
  • 고경희 (차의과대학교 영상의학과) ;
  • 노지영 (차의과대학교 영상의학과) ;
  • 문희정 (연세대학교 의과대학 영상의학과) ;
  • 김은경 (연세대학교 의과대학 영상의학과) ;
  • 김민정 (연세대학교 의과대학 영상의학과) ;
  • 박병우 (연세대학교 의과대학 영상의학과)
  • Published : 2011.06.01

Abstract

Purpose: To evaluate the surgical outcomes of fibroepithelial lesion with cellular stroma (FELCS) diagnosed at sonography guided core needle biopsy of breast masses, and to determine whether the clinical and imaging features of this lesion could predict the presence of a phyllodes tumor. Materials and Methods: We retrospectively reviewed the pathologic results of sonography guided core needle biopsy of solid breast masses. A total of 55 FELCS diagnosed with this procedure that underwent subsequent surgical excision were included in this study; their medical records and radiologic images were retrospectively reviewed. Results: The results of the surgical excision revealed 22 (40%) phyllodes tumors and 33 (60%) non-phyllodes tumors: 30 (54.6%) fibroadenomas, 1 (1.8%) adenosis, 1 (1.8%) fibrocystic changes and 1 (1.8%) fibroadenomatous hyperplasia. Lesion size and patient age were significantly different between phyllodes tumors and nonphyllodes tumors groups (32.2 ${\pm}$ 14.07 mm/22.4 ${\pm}$ 13.64 mm, p=0.0078, 43.5 ${\pm}$ 11.60 years/36.5 ${\pm}$ 10.25 years, p=0.0207). Among the sonographic features, only cleft was significantly more visible in phyllodes tumors than in non-phyllodes tumors (n=14 (70%)/n=6 (30%), p=0.0016). Conclusion: The size of the lesions, the age of the patients, and the sonographic features of cleft were the significant helpful variables to predict phyllodes tumors among FELCS diagnosed at breast core biopsy.

목적: 유방의 중심부바늘생검에서 진단된 세포충실성섬유상피병변(fibroepithelial lesion with cellular stroma)의 수술 후의 진단 결과와 엽상종양을 예측하는 데 도움이 되는 임상적 혹은 영상학적 인자가 있는지를 알아보고자 하였다. 대상과 방법: 초음파유도하 중심부바늘생검에서 세포충실성섬유상피병변으로 진단되고 수술을 시행하여 최종병리가 확인된 55명을 대상으로 하였다. 병변의 수술 결과에 따라 엽상종양과 엽상종양이 아닌 병변의 두 부류로 나눈 후 각각의 임상과 영상소견을 후향적으로 비교, 분석하였다. 또한, 엽상 종양을 예측하는데 유의한 변수들을 조합하여 분석하였다. 결과: 수술로 확진된 55명의 55예의 병변 중 엽상 종양은 22예(40%), 엽상종양이 아닌 예가 33예(섬유선종 30예(54.6%), 섬유낭종변화 1예(1.8%), 선증 1예(1.8%), 섬유선증증식 1예(1.8%))였다. 엽상종양 22예의 평균 크기는 32.2 ${\pm}$ 14.07 mm (12~55 mm)였고 22명 환자의 평균나이는 43.5 ${\pm}$ 11.60세(18~69세)였으며 엽상종양이 아닌 종양 33예의 평균 크기는 22.4 ${\pm}$ 13.64 mm (12~55 mm), 33명의 평균 나이는 36.5 ${\pm}$ 10.25세(19~62세)로 크기와 나이 모두 통계적으로 유의한 차이를 보였다(p=0.0078, p=0.0207). 초음파 소견 중에서는 틈새(cleft)가 통계적으로 유의한 차이를 보여 엽상종양에서 더 흔하게 관찰되었다(n=14 (70%)/n=6 (30%), p=0.0016). 결론: 유방의 수술 전 중심부바늘생검에서 진단된 세포충실성섬유상피병변 중 병변의 크기, 환자의 나이, 초음파 소견에서 틈새의 유무를 고려하면 엽상종양을 예측할 수 있다.

Keywords

References

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