Başak ERDEMLİ GÜRSEL, Sahsine TOLUNAY, Sedat Giray KANDEMİRLİ, Naile BOLCA TOPAL, Dr. Öğr. Üyesi Mehmet Onur KAYA

Memenin Fibroepitelyal Lezyonlarının US Bulgularının Eksizyonel Biyopsi Sonuçlarıyla Karşılaştırılması

Çalışmamızın amacı, ultrasonografi (US) eşliğinde kesici iğne biyopsi (KİB) sonucu fibroepitelyal lezyon (FEL) olan lezyonların klinik ve US bulgularını, patolojik ayrımda kullanılan Ki-67 indeksini, eksizyonel biyopsi sonuçlarıyla karşılaştırarak ayırımda yararlı olabilecek bulguların araştırılmasıdır. 2009-2013 yılları arasında US eşliğinde KİB yapılmış 50 olguda, sonucu FEL olan 53 lezyon değerlendirilmiştir. Elliüç lezyonun 43’ü histopatolojik olarak FA, 10 tanesi de filloides tümör (FT) tanısı almıştır. Hastaların klinik bulguları, lezyonların BIRADS sınıflamasına göre yapılan ultrasonografik özellikleri ve KİB preparatlarının Ki-67 proliferatif indeks değerleri belirlenmiştir. Ayrıca meme radyolojisi konusunda 20 yıllık deneyim olan bir radyolog, eksizyon sonuçlarını bilmeden, lezyonların sonografik görüntülerini yorumlamıştır. Buna göre hiçbir klinik ve ultrasonografik parametrenin FA ve FT ayrımında özgün olmadığı sonucuna ulaşılmıştır. KİB preparatlarından yapılan Ki-67 proliferatif indeks değerleri de ayırıcı tanıya katkı sağlamamıştır. Ancak meme radyolojisi konusunda uzman radyoloğun öngörüsü ile cerrahi sonuçlar arasında istatistiksel olarak anlamlı uyumluluk bulunmuştur. Bu nedenle KİB sonucu FEL gelen ancak uzman radyoloğun benign olarak yorumladığı seçilmiş olgularda yakın takip alternatif bir seçenek olarak değerlendirilebilir.

Anahtar Kelimeler:

Fibroepiteliyal Lezyon (FEL), Ultrasonografi (US), Meme, Kesici İğne Biyopsisi (KİB)

Comparison of Ultrasonographic Features of Fibroepitelial Lesions of the Breast with Excisional Biopsy Results

In this study, we have retrospectively reviewed our archive between January 2009 and November 2013 for breast lesions that had a diagnosis of fibroepithelial lesion on core needle biopsy that underwent surgical excision. We have identified 53 FEL and retrospectively reviewed sonographic images based on BI-RADS lexicon. We have compared sonographic findings to Ki-67 indices and excisional biopsy results. Patient characteristics, presenting symptoms, clinical and physical examination findings and Ki-67 proliferation index of the core-needle biopsy spesimens were retrieved from patient archive. A radiologist with 20 years of experience in breast radiology, retrospectively tried to differentiate FA from PT based on sonographic images blind to the clinical and histopathological data. In accordance with the available literature, sonographic features based on BI-RADS classification and clinical features in our study were not able to discriminate between FA and PT. Additionally, Ki-67 staining of core needle biopsy specimens did not allow specific discrimination of FA from PT. Our study indicates that patients with a pathological diagnosis of FEL on core needle biopsy along with findings suggestive of benign features as identified by an expert radiologist can be managed conservatively with a close follow-up.

Keywords:

Fibroepithelial Lesion (FEL), Ultrasound (US), Breast, Core Needle Biopsy (CNB),

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