Emrah DOĞAN, Leyla TEKİN, Neşat ÇULLU, Murat POLAT

Fibroadenomlara Yapılan Gereksiz Biyopsiler, Nasıl Oranlarını Düşürebiliriz?

Fibroadenoma malign transformasyon riski çok düşük olan benign formda bir meme tümörüdür. Genç yaşta daha yaygındır ve insidansı yaş ile düşer. Tanısı sıklıkla ultrasonografi ile konur. Eksizyon yerine genellikle radyolojik izlem yapılır. Buna rağmen meme biyopsilerinin yarısı fibroadenomlara yapılmaktadır. Araştırmamızın konusu fibroadenomlara yapılan gereksiz biyopsilerin nasıl düşürülebileceği hakkındadır. Araştırma Fibroadenom tanısı almış 39 hastayı kapsayan retrospektif bir çalışmadır. (ortalama yaş 48.8±7.7). Ultrasonografi ile lezyonların özellikleri analiz edildi. Boyut, lokalizasyon, kontür, oryantasyon, homojenite, ekojenite, tek ya da multipl olması, kalsifikasyon özelliklerine göre sınıflandırıldı . Ayrıca lezyonların BIRADS grupları belirtildi. Son olarak lezyonlar biyopsi yapılma nedenlerine göre sınıflandırıldı. Lezyonların ultrasonografik özellikleri ile ilgili tüm bulgular literatürle uyumluydu. Bir hasta hariç tüm hastalar BIRADS grubuna göre düşük riskli gruptaydı. Araştırmamızda biyopsi yapılan hastaların 2/3’ü ilk kez ultrasonografik takibe giren hastalardı ve 1/3’ü şüpheli özelliklere sahipti. Literatürde belirtilen biyopsi endikasyonlarına göre hasta 40 yaşına gelmeden ya da kitle ele gelmeden yapılan bir ultrasonografik muayene ile lezyona ait referans bir döküman bulunduğunda fibroadenomlara yapılan gereksiz biyopsi oranı azaltılabilir.

Anahtar Kelimeler:

Fibroadenoma, Meme, Tru-cut Biyopsi, Ultrasonografi

Unnecessary Biopsy For Fibroadenomas, How Can We Decrease Its Rate?

Fibroadenoma (FA) is benign form of tumors of the breast with a very low risk of transformation to malignity. It is very common among young women and incidence drops with age. Diagnosis is often made by ultrasonography (US). Instead of excision for diagnosis, following is made by imaging. Currently, FA amount for about half of the biopsies of breast. The objective of our study is to find by which mean we can decrease the rate of unnecessary biopsies. We made a retrospective study on 39 patients labelled as FA (mean age 48.8±7.7 years). We analyzed the features of lesions in US: size, localization, contour, orientation, homogeneity, echogenicity, single or multiple, presence or absence of calcifications. We classified our masses according to BIRADS categorization and also calculated the rate of masses according to indications of biopsies. Concerning the ultrasonographic description of FA’s features, all of our findings were compatible with literature. Except one patient, all of them were classified as less suspicious according to BIRADS categorization. 2/3 of biopsies in our sample were made in the first examination and 1/3 presented suspicious features. A high amount of biopsy is indicated in the first contact with patients because there is no previous examination to refer to. We suggest to not wait for patient to be aware of the mass or for systematic examination set at the age of 40 and to make earlier US in purpose to have a documented reference of masses’ features which are well established according to literature in order to avoid unnecessary biopsies.

Keywords:

Fibroadenoma, Breast, Tru-cut Biopsy, Ultrasonography,

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