DOI QR코드

DOI QR Code

무증상 여성의 유방초음파에서 발견된 군집 미세낭종

Clustered Microcysts Detected on Breast US in Asymptomatic Women

  • 김현진 (동아대학교 의과대학 동아대학교의료원 영상의학과) ;
  • 이진화 (동아대학교 의과대학 동아대학교의료원 영상의학과) ;
  • 박영미 (인제대학교 의과대학 부산백병원 영상의학과) ;
  • 임경재 (동아대학교 의과대학 동아대학교의료원 영상의학과)
  • Hyun Jin Kim (Department of Radiology, Dong-A University Medical Center, Dong-A University College of Medicine) ;
  • Jin Hwa Lee (Department of Radiology, Dong-A University Medical Center, Dong-A University College of Medicine) ;
  • Young Mi Park (Department of Radiology, Busan Paik Hospital, Inje University College of Medicine) ;
  • Kyungjae Lim (Department of Radiology, Dong-A University Medical Center, Dong-A University College of Medicine)
  • 투고 : 2022.03.18
  • 심사 : 2022.09.20
  • 발행 : 2023.05.01

초록

목적 본 연구는 무증상 여성의 유방 초음파에서 발견된 군집 미세낭종의 발생률, 임상적 결과 및 영상 소견을 알아보고, 적절한 조치 가이드라인을 제시하고자 한다. 대상과 방법 2014년 8월부터 2019년 12월까지 무증상 여성에서 시행한 유방 초음파에서 발견된 군집 미세낭종 병변에 대해 분석하였다. 최종 진단은 병리학적 결과 및 12개월 이상의 추적관찰로 하였다. 결과 100명의 환자에서 117개 병변이 후향적으로 연구되었으며, 군집 미세낭종의 발생률은 1.5%였다. 총 117개의 병변 중, 3개(2.6%)는 악성, 2개(1.7%)는 고위험 병변, 112개(95.7%)는 양성이었다. 악성 병변 중 2개는 관상피내암이었고, 1개는 침윤성 유관암이었다. 이중, 유방 촬영술에서 의심스러운 미세석회화 또는 초음파에서 내부 혈류를 보인 2개의 병변은 category 4로 분류되었다. 나머지는 12개월 뒤 시행한 초음파에서 echo pattern의 변화를 보인 위 음성의 증례였다. 결론 무증상 여성에서 시행한 유방 초음파에서 군집 미세낭종의 유병률은 1.5%였으며, 악성률은 2.6%였다. 군집 미세낭종의 악성률과 양성 및 악성 영상 소견을 아는 것은 영상의학과 의사들이 병변을 분류하고 적절한 조치를 권유하는 데 도움이 될 것이다.

Purpose To investigate the incidence, outcomes, and imaging characteristics of clustered microcysts detected on breast US in asymptomatic women, and suggest appropriate management guidelines. Materials and Methods We identified and reviewed the lesions recorded as "clustered microcysts" on breast US performed in asymptomatic women between August 2014 and December 2019. The final diagnosis was based on pathology and imaging follow-up results for at least 12 months. Results The incidence was 1.5% and 100 patients with 117 lesions were included. Among 117 lesions, 3 (2.6%), 2 (1.7%), and 112 (95.7%) were malignant, high-risk benign, and benign lesions, respectively. The malignant lesions included two cases of ductal carcinoma in situ and one invasive ductal carcinoma. Two of them were assessed as category 4, showing mammographic suspicious microcalcifications and internal vascularity on Doppler US. The remainder was a false negative case and showed echo pattern change on the 12-month follow-up US. Conclusion The incidence of clustered microcysts on breast US in asymptomatic women was 1.5% and malignancy rate was 2.6% (3 of 117). Knowledge of outcomes and imaging features of benign and malignant clustered microcysts may be helpful for radiologists, thereby aiding categorization and management recommendations.

키워드

참고문헌

  1. Berg WA. Sonographically depicted breast clustered microcysts: is follow-up appropriate? AJR Am J Roentgenol 2005;185:952-959  https://doi.org/10.2214/AJR.04.0929
  2. Berg WA, Sechtin AG, Marques H, Zhang Z. Cystic breast masses and the ACRIN 6666 experience. Radiol Clin North Am 2010;48:931-987  https://doi.org/10.1016/j.rcl.2010.06.007
  3. Warner JK, Kumar D, Berg WA. Apocrine metaplasia: mammographic and sonographic appearances. AJR Am J Roentgenol 1998;170:1375-1379  https://doi.org/10.2214/ajr.170.5.9574619
  4. Wellings SR, Jensen HM, Marcum RG. An atlas of subgross pathology of the human breast with special reference to possible precancerous lesions. J Natl Cancer Inst 1975;55:231-273 
  5. D'Orsi CJ, Sickles EA, Mendelson EB, Morris EA. ACR BI-RADS atlas, breast imaging reporting and data system. Reston, VA: American College of Radiology 2013 
  6. Goldbach AR, Tuite CM, Ross E. Clustered microcysts at breast US: outcomes and updates for appropriate management recommendations. Radiology 2020;295:44-51  https://doi.org/10.1148/radiol.2020191505
  7. Greenwood HI, Lee AY, Lobach IV, Carpentier BM, Freimanis RI, Strachowski LM. Clustered microcysts on breast ultrasound: what is an appropriate management recommendation? AJR Am J Roentgenol 2017;209:W395-W399  https://doi.org/10.2214/AJR.17.17813
  8. Berg WA, Campassi CI, Ioffe OB. Cystic lesions of the breast: sonographic-pathologic correlation. Radiology 2003;227:183-191  https://doi.org/10.1148/radiol.2272020660
  9. Chang YW, Kwon KH, Goo DE, Choi DL, Lee HK, Yang SB. Sonographic differentiation of benign and malignant cystic lesions of the breast. J Ultrasound Med 2007;26:47-53  https://doi.org/10.7863/jum.2007.26.1.47
  10. Daly CP, Bailey JE, Klein KA, Helvie MA. Complicated breast cysts on sonography: is aspiration necessary to exclude malignancy? Acad Radiol 2008;15:610-617  https://doi.org/10.1016/j.acra.2007.12.018
  11. Tanaka A, Imai A, Goto M, Konishi E, Shinkura N. Which patients require or can skip biopsy for breast clustered microcysts? Predictive findings of breast cancer and mucocele-like tumor. Breast Cancer 2016;23:590-596  https://doi.org/10.1007/s12282-015-0607-x
  12. Berg WA. Reducing unnecessary biopsy and follow-up of benign cystic breast lesions. Radiology 2020;295:52-53 https://doi.org/10.1148/radiol.2020200037