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DOI: 10.1055/s-0029-1245243
© Georg Thieme Verlag KG Stuttgart · New York
Value of Ultrasound in Preoperative Local Staging in Early Breast Cancer
Wertigkeit der Mammasonografie in der Größendetektion von HerdläsionenPublication History
received: 21.5.2009
accepted: 2.2.2010
Publication Date:
20 April 2010 (online)
Zusammenfassung
Ziel: Ziel der vorliegenden Arbeit war es, die Übereinstimmung der Metrik von intramammären Herdläsionen zwischen Mammasonografie und histologischem Präparat zu untersuchen und mögliche Einflussfaktoren auf Untersuchungsdiskrepanzen zu charakterisieren. Material und Methoden: Bei 460 Patientinnen, von denen 445 maligne Läsionen aufwiesen, wurden retrospektiv die sonografischen Ergebnisse mit den Maßen des Operationspräparates verglichen. Des Weiteren wurde der Datensatz nach Histologie, Tumorstadium, Alter, Grading und neoadjuvanter Therapie analysiert. Ergebnisse: Der Vergleich zwischen Mammasonografie und Operationspräparat zeigt eine exakte Größenmessung der Läsionen vor allem im Stadium T 1 und T 2 und bei duktal invasiven Karzinomen. Mit höherem Tumorstadium wird die Sonografie in der Messung ungenauer. Alter und Grading beeinflussen die Messgenauigkeit der Sonografie nicht. Lobulär invasive Mammakarzinome weisen ebenfalls eine hohe Ungenauigkeit auf. Schlussfolgerung: Je größer das Tumorstadium, desto ungenauer wird die Mammasonografie. Da die Unterschiede in der Messgenauigkeit sowohl in der univariaten, wie auch in der multivarianten Analyse gleich sind, ist davon auszugehen, dass Tumorstadium und histologischer Typ aufeinander keinen Einfluss im Sinne der Messgenauigkeit haben.
Abstract
Purpose: The purpose of this study was to determine the precision of breast ultrasound for the measurement of breast lesions compared to the histological measurement. A number of other dependent variables were also analyzed. Material and Methods: 460 patients with 445 malignant lesions were examined using breast ultrasound and the lesions were measured and compared to the histologically measured size. The data was further analyzed according to histology, tumor stage, age, grading and therapy. Results: Metric comparison showed good correlation between sonography and the pathologically measured size of breast lesions, especially in tumor stage T 1 and T 2 and within ductal invasive carcinomas. Higher tumor stages lead to imprecise measurements and the histological type of lobular invasive carcinoma also results in imprecise measurements. Age and grading do not influence measurement precision. Conclusion: Breast ultrasound allows precise measurement of breast lesions especially at lower tumor stages. The higher the tumor stage, the more imprecise the measurement becomes. Multivariate analysis shows no cross impact between tumor stage and histological type with respect to the quality of measurement.
Key words
breast - mammography - ultrasound 2D
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1 * Contributed equally: D. Verga, A. Wöckel
Dr. Dominic Varga
Frauenklinik, Universitätsklinik Ulm
Prittwitzstrasse 43
89075 Ulm
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