PDF(Pubmed)
Abstract：
OBJECTIVE: In April 2020, standard two-dimensional (2D) full-field digital mammograms were replaced with digital breast tomosynthesis (DBT) and synthesised 2D views for symptomatic breast clinics. This study aimed to evaluate the positive predictive value (PPV) for malignancy in DBT-detected Architectural distortion (AD).
METHODS: All mammogram reports with the word \"distortion\" were assessed between April 2020 and October 2022. There were 458 mammograms with the word \"distortion.\" After excluding mammograms with no distortion (n = 128), post-surgical distortion (n = 173), distortion with mass (n = 33), and unchanged distortion (n = 14), there were 111 patients with pure distortion. Correlation with histopathology was obtained where possible. All patients were followed for a minimum of 2 years.
RESULTS: Forty-two out of 111 patients (37.84%) with AD had a normal ultrasound (US) and were discharged. Fifty-five (49.5%) patients had sonographic correlation corresponding to the distortion, leading to US-guided biopsy. Thirteen (23.6%) had tomosynthesis-guided biopsy, and one had a skin biopsy. The PPV for malignancy was 42.34%. Malignancy diagnoses were higher with US-guided biopsies than tomosynthesis-guided biopsies, 78.1% and 30%, respectively.
CONCLUSIONS: With a total malignancy rate of 42.34%, DBT-detected AD has a high enough PPV for malignancy to justify selective tissue sampling if a sonographic correlate is present or with suspicious mammograms. The chances of malignancy are higher when a sonographic correlate corresponding to AD is present.
CONCLUSIONS: AD on DBT/synthesized mammograms views in symptomatic breast clinic patients justifies selective sampling.
METHODS: All mammogram reports with the word \"distortion\" were assessed between April 2020 and October 2022. There were 458 mammograms with the word \"distortion.\" After excluding mammograms with no distortion (n = 128), post-surgical distortion (n = 173), distortion with mass (n = 33), and unchanged distortion (n = 14), there were 111 patients with pure distortion. Correlation with histopathology was obtained where possible. All patients were followed for a minimum of 2 years.
RESULTS: Forty-two out of 111 patients (37.84%) with AD had a normal ultrasound (US) and were discharged. Fifty-five (49.5%) patients had sonographic correlation corresponding to the distortion, leading to US-guided biopsy. Thirteen (23.6%) had tomosynthesis-guided biopsy, and one had a skin biopsy. The PPV for malignancy was 42.34%. Malignancy diagnoses were higher with US-guided biopsies than tomosynthesis-guided biopsies, 78.1% and 30%, respectively.
CONCLUSIONS: With a total malignancy rate of 42.34%, DBT-detected AD has a high enough PPV for malignancy to justify selective tissue sampling if a sonographic correlate is present or with suspicious mammograms. The chances of malignancy are higher when a sonographic correlate corresponding to AD is present.
CONCLUSIONS: AD on DBT/synthesized mammograms views in symptomatic breast clinic patients justifies selective sampling.
摘要：
目标：2020年4月，标准的二维全视场数字乳房X线照片（FFDM）被数字乳腺断层合成术（DBT）取代，并为有症状的乳腺诊所合成了2D视图。本研究旨在评估DBT检测到的建筑失真（AD）中恶性肿瘤的阳性预测值。
方法：在2020年4月至2022年10月期间评估了所有带有“变形”字样的乳房X线照片报告。有458张乳房X线照片，上面写着“变形”。排除乳房X线照片后，没有变形（n=128），术后变形（n=173），质量失真(n=33)，和不变的失真（n=14），有111例纯变形患者。在可能的情况下获得与组织病理学的相关性。所有患者随访至少两年。
结果：111例AD患者中有42例（37.84％）的超声（US）正常并出院。55例（49.5%）患者有与畸变相对应的超声相关性，导致美国引导活检。13例（23.6%）进行断层合成引导活检，还有一个做了皮肤活检.恶性肿瘤的阳性预测值（PPV）为42.34％。美国引导活检的恶性诊断高于断层合成引导活检。78.1%和30%，分别。
结论：总恶性率为42.34%，DBT检测到的建筑扭曲具有足够高的PPV，用于恶性肿瘤，如果存在超声相关性或可疑的乳房X线照片，则可以进行选择性组织采样。当存在对应于AD的超声相关性时，恶性肿瘤的机会更高。
结论：症状性乳腺门诊患者DBT/SM观点的结构失真证明了选择性采样的合理性。
方法：在2020年4月至2022年10月期间评估了所有带有“变形”字样的乳房X线照片报告。有458张乳房X线照片，上面写着“变形”。排除乳房X线照片后，没有变形（n=128），术后变形（n=173），质量失真(n=33)，和不变的失真（n=14），有111例纯变形患者。在可能的情况下获得与组织病理学的相关性。所有患者随访至少两年。
结果：111例AD患者中有42例（37.84％）的超声（US）正常并出院。55例（49.5%）患者有与畸变相对应的超声相关性，导致美国引导活检。13例（23.6%）进行断层合成引导活检，还有一个做了皮肤活检.恶性肿瘤的阳性预测值（PPV）为42.34％。美国引导活检的恶性诊断高于断层合成引导活检。78.1%和30%，分别。
结论：总恶性率为42.34%，DBT检测到的建筑扭曲具有足够高的PPV，用于恶性肿瘤，如果存在超声相关性或可疑的乳房X线照片，则可以进行选择性组织采样。当存在对应于AD的超声相关性时，恶性肿瘤的机会更高。
结论：症状性乳腺门诊患者DBT/SM观点的结构失真证明了选择性采样的合理性。
