Halil Fırat BAYTEKİN, Mustafa Gökhan ÜNSAL, Enis ÖZTÜRK, Halil ALIŞ, Selin KAPAN, Muhammet Ferhat ÇELİK, Ahmet SÜREK, Ahmet Cem DURAL

Görüntüleme Yöntemleri ile Benign Bulgular Gösteren Fibroadenomlarda Uzun Aks/Kısa Aks Oranları Malignite Tahmini Üzerine Kullanışlı Bir Gereç Olabilir mi?

Amaç: Bu çalışmada görüntüleme yöntemleri sonrası fibroadenom (FA) ön tanısı alan meme kitlelerinin uzun ve kısa aks oranlarının hesaplanması ve elde edilen bulguların malignite için prognostik öneminin olup olmadığının araştırılması amaçlanmıştır. Gereç ve Yöntem: Ocak 2011-Mart 2014 yılları arasında görüntülemede solid lezyon saptanıp tru-cut biyopsi yapılan 1154 hasta değerlendirildi. Bu hastalardan ultrasonografi değerlendirmesine göre FA olarak tanımlanan hastalar (n=707) çalışmaya dahil edildi. Uzun aks cilde paralel olacak şekilde sadece bir veya iki lobulasyonu olan ya da düzgün sınırlı, homojen ekojenitesi olan lezyonlarda ölçüldü. Hastaların demografik verileri, klinik özellikleri, görüntüleme ve patoloji sonuçları değerlendirildi. Bulgular: Hastaların 13’ünde (%1,8) patoloji sonucu malignite ile uyumlu olarak sonuçlandı. Bunlardan ikisi 40 yaş idi (p=0,003). Uzun aks/kısa aks oranı benign olgularda 1,8 iken malign olgularda 1,4 idi. Bu iki oran arası eşik değer 1,4 olarak ölçüldü (p=0,001). Lezyonlar çoğunlukla sağ tarafta ve üst dış kadran (n=394, %55,7 ve n=389, %55, sırası ile) yerleşimli idi. Lokalizasyona göre malignite oranı benzer idi. Sonuç: Görüntüleme yöntemleri sonrası FA ön tanısı alan smeme kitleleri sonografik olarak benign özellikler gösterse de uzun aks/kısa aks oranının eşik değeri 1,4’ten küçük ise malignite oranı artabilir. Bu hastalarda 40 yaş üstü ve risk faktörü de mevcutsa detaylı patolojik incelemenin göz ardı edilmemesi gerektiğini düşünmekteyiz.

Long Axis to Short Axis Ratio of Breast Masses Pre-Diagnosed as Fibroadenomas on Ultrasonography. Can it Be a Useful Tool in Predicting Malignancy?

Objectives: The purpose of this study was to calculate the long-axis-to-short axis ratio of breast masses pre-diagnosed as fibroadenoma (FA) onultrasonography and determine its role in predicting malignancy.Materials and Methods: Between January 2011 and March 2014, 1,154 patients who underwent tru-cut biopsy for the evaluation of solid breastmasses encountered on imaging were evaluated. Of these, patients with breast masses that were diagnosed as FA based on ultrasonographic findingswere included (n=707) into the study. The long axis ratio of lesions with only 1-2 lobulations or had well circumscribed borders, homogenousechogenicity was measured parallel to the skin. The patient’s clinical characteristics and demographic data, imaging and pathology findings werereviewed.Results: Pathology findings revealed malignancy in 13 (1.8%) patients. Two of these were 40 years (p=0.003). Thelong axis-short axis ratio was 1.8 for the benign cases and 1.4 for the malignant cases. The cut off value of the two ratios was calculated to be 1.4(p=0.001). Most of the lesions were on right side and upper outer quadrant (n=394, 55.7% and n=389, 55% respectively). The rate of malignancywas similar according to location.Conclusion: Breast masses diagnosed as FA based on imaging with a long axis to short axis ratio less than 1.4 may be at an increased riskfor malignancy despite the presence of benign sonographic features. In patients older than 40 with notable risk factors, a detailed review ofpathological findings is strongly encouraged.

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