Pınar BALCI, Kemal Çağlar TUNA, Merih GÜRAK DURAK, Süleyman Özkan AKSOY, Işıl BAŞARA AKIN, Canan ALTAY

MULTİFOKAL/MULTİSENTRİK MEME KANSERİNDE DİJİTAL TOMOSENTEZİN TANISAL ETKİNLİĞİ: PİLOT ÇALIŞMA

Amaç: Multifokal/multisentrik meme karsinomu (M/MMK), aynı kadrandan gelişen iki veya daha fazla odak olan olgularda tanımlanır. Dijital tomosentezin (DTS) dijital mamografiye (DM) eklenmesi meme lezyonları- nın ve malignitelerin tanısı arttırır. Multifokal lezyon saptanmasında DM’nin düşük duyarlılığı ultrasonografi- nin (US) eklenmesiyle arttırılır. Ancak Manyetik rezonans görüntüleme (MRG) M/MMK tanısında en yüksek duyarlılığa sahiptir. Çalışmamızda M/MMK’de DTS’in tanısal değerinin US eklenerek ve eklenmeden, MRG ile kaşılaştırılmalı değerlendirilerek, saptanması amaçlanmıştır. Gereç ve Yöntemler: 2014 Nisan-2017 Mart tarihleri arasında M/MMK ön tanısı alan 64 hasta çalışmamıza dahil edilmiştir. DTS, US ve MRG ayrı ayrı değerlendirilmiştir. Değerlendirme tek radyolog tarafından retros- pektif olarak yapılmıştır. Lezyonlar ve foküsler, DTS’de kalsifikasyonlar, spiküler kitleler ve asimetrik fibrog- landüler doku varlığına göre sınıflanmıştır. Hastaların ortalama değerleri one-way analysis of variance (ANO- VA) ile değerlendirilmiştir. Bağımlı değişkenlerde çapraz tablolar ve Ki-Kare testleri kullanılmıştır. P

Effectiveness of Digital Tomosynthesis in Multifocal/ Multicentric Breast Cancer: A Pilot Study

Purpose: Multifocal/multicentric breast carcinoma (M/MBC) is defined in cases with two or more foci in sameand different quadrants of breasts. Digital breast tomosynthesis (DBT) addition to digital mammography(DM) increases the diagnosis of breast lesions and malignancies. While DM, has low sensitivity in multifocallesion detection, additional ultrasonography (US) increases diagnostic performance. However, magneticresonance imaging (MRI) has the highest sensitivity in M/MBC determination. We here aimed to investigatediagnostic value of DBT with and without additional US examination in M/MBC. We evaluated our resultswith MRI comparatively.Material and Methods: Between April 2014-March 2017, 64 patients with pre-diagnosis of M/MBC wereenrolled study. DBT, US, and MRI were reviewed separately. One breast radiologist carried out the review,retrospectively. MRI findings were accepted as gold standard. Lesions and foci of M/MBC in DBT wereclassified by presence of calcifications, spiculate masses and asymmetric fibroglandular tissues. Patients’mean data were compared by one-way analysis of variance (ANOVA). Interrelated variables were evaluatedby using cross tables and Qui Square Tests. P value was accepted as p < 0.05.Results: DBT diagnosed 53 breasts in 52 patients as M/MBC. Sensitivity of DBT was 76.1%, specificity was83.3% (p=0.77). US evaluation revealed that 46 breasts in 45 patients had M/MBC. Sensitivity and specificityof US were 74.1% and 78.8%, respectively (p=0.1). US addition to DBT increased sensitivity to 94,2%.Conclusion: MRI detects lesions, lesion spread and the dimensions with high accuracy. It is importantthat, in M/MBC, US and MRI addition to DBT provides false positivity and negativity decrease, preventsreoperations.

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