بررسی یافته‌های مربوط به تراکم غیرعادی پستان در ماموگرافی و ارتباط آن‌ها با میزان بدخیمی: یک مطالعه توصیفی در شهرستان جهرم، 1398

نوع مقاله : اصیل پژوهشی

نویسندگان

1 مربی گروه بیهوشی، مرکز تحقیقات مؤلفه‌های اجتماعی نظام سلامت، دانشکده پزشکی، دانشگاه علوم پزشکی جهرم، جهرم، ایران.

2 دانشجوی پزشکی، کمیته تحقیقات دانشجویی، دانشکده پزشکی، دانشگاه علوم پزشکی جهرم، جهرم، ایران.

3 دانشجوی کارشناسی مامایی، دانشکده مامایی، دانشگاه آزاد اسلامی واحد جهرم، جهرم، ایران.

4 استادیار گروه جراحی، مرکز تحقیقات سلامت و بیماری‌های زنان، دانشکده پزشکی، دانشگاه علوم پزشکی جهرم، جهرم، ایران.

10.22038/ijogi.2023.23287

چکیده

مقدمه: سرطان پستان، از رایج‌ترین سرطان‌ها در میان زنان در سراسر دنیا می‌باشد. ماموگرافی به‌عنوان ابزاری برای کشف زودرس سرطان‌های غیرقابل لمس پستان، هم در غربالگری و هم در کشف بیماری دارای ارزش تشخیصی است. مطالعه حاضر با هدف بررسی بررسی یافته‌های مربوط به تراکم غیرعادی در پستان و ارتباط آن ها با میزان بدخیمی انجام شد.
روش‌کار: این مطالعه توصیفی تحلیلی در سال 1398 بر روی 150 بیمار با نتیجه ماموگرافی تراکم غیرعادی پستان مراجعه کننده به کلینیک خاتم‌الانبیاء شهرستان جهرم صورت گرفت. متغیرهایی مانند ظاهر ضایعه در سونوگرافی، وجود یا عدم وجود توده، نوع توده و محل ضایعه در سونوگرافی مورد بررسی قرار گرفت و سپس ارزیابی هورمونی و پاتولوژی در صورت نیاز انجام شد. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار SPSS (نسخه 19) و آزمون‌های کای اسکوئر و تی تست انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته ­ها: از 150 بیمار مورد بررسی، 134 مورد تراکم غیر عادی پستان در ماموگرافی مشاهده شد. توزیع سنی افرادی که یافته­ های ماموگرافی آنها نشان از وجود تراکم غیرعادی داشت، در مقایسه با بیماران بدون تراکم غیرعادی، تفاوت معنی‌داری نشان نداد. یافته ماموگرافی شامل نرمال بودن، خوش‌خیم، مشکوک، مرزی و بدخیم ارتباط معنی‌داری با وجود یا عدم وجود تراکم ناهمسان محوری داشت (001/0=p). نمره BI-RADS نیز ارتباط معنی‌داری با وجود یا عدم وجود تراکم ناهمسان محوری در ماموگرافی داشت (001/0=p). پاتولوژی فقط برای 21 مورد انجام شده بود. بر اساس این تست، حساسیت و اختصاصیت تراکم غیرعادی برای بدخیمی برابر 64/63% و 20% تعیین شد.
نتیجه­ گیری: با توجه به حساسیت و اختصاصیت مثبت بودن تراکم غیرعادی در ماموگرافی، برای بررسی­ های تکمیلی و بالا بردن ارزش تشخیصی، نیاز به استفاده از سایر روش ­های غربالگری در کنار ماموگرافی برای بیماران مستعد تراکم غیرعادی می‌باشد.

کلیدواژه‌ها

عنوان مقاله [English]

The findings related to focal asymmetry density of breast in mammography and their relationship with malignancy rate: A descriptive study in Jahrom city, 2019

نویسندگان [English]

  • Navid Kalani 1
  • Maryam Sadat Hosseini 2
  • Zahra Mosalanezhad 3
  • Lohrasb Taheri 4
  • Marzieh Haghbeen 4
1 Instructor, Department of Anesthesiology, Research Center for Social Determinants of Health, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
2 General practitioner, Student Research Committee, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
3 Midwifery Bachelor Student, School of Midwifery, Islamic Azad University, Jahrom Branch, Jahrom, Iran.
4 Assistant Professor, Department of Surgery, Women’s Health and Diseases Research Center, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
چکیده [English]

Mammography has diagnostic value as a tool for the early detection of intangible breast cancers, both in screening and in the detection of disease. The present study was performed with aim to evaluate the findings related to focal asymmetry density of breast and their relationship with malignancy rate.
Methods: This descriptive analytical study was performed in 2019 on 150 patients with focal asymmetric density mammography referred to Khatam Al-Anbia Clinic of Jahrom city. Variables such as the appearance of the lesion on ultrasound, the presence or absence of a mass, the type of mass and the location of the lesion on ultrasound were examined and then hormonal and pathological evaluation was performed if necessary. Data analysis was done using SPSS software (version 19) and Chi-square and t-test. P<0.05 was considered statistically significant.
Results: Out of 150 patients, 134 cases of focal asymmetry density (FAD) were observed on mammography. The age distribution of people whose mammographic findings showed the presence of FAD did not show a significant difference compared to patients without FAD (P=0.728). The outer upper quadrant or UOQ with 84 cases (56%) is the most common site of FAD involvement. Mammographic findings including normal, benign, suspected, borderline and malignant were significantly associated with the presence or absence of FAD (P=0.001). BI-RADS score was also significantly associated with the presence or absence of FAD in mammography (P=0.0001). The pathology was performed only for 21 cases. Based on this test, the sensitivity and specificity of focal asymmetry density for malignancy were determined as 63.64% and 20.00%.
Conclusion: Considering to the sensitivity and specificity of positive focal asymmetric density in mammography, for additional studies and to increase the diagnostic value, it is necessary to use other screening methods along with mammography for patients prone to focal asymmetric density.

کلیدواژه‌ها [English]

  • Breast cancer
  • Mammography
  • Physical Examination

مراجع

  1. Samardar P, de Paredes ES, Grimes MM, Wilson JD. Focal asymmetric densities seen at mammography: US and pathologic correlation. Radiographics 2002; 22(1):19-33.
  2. Lehman C, Holt S, Peacock S, White E, Urban N. Use of the American College of Radiology BI-RADS guidelines by community radiologists: concordance of assessments and recommendations assigned to screening mammograms. American Journal of Roentgenology 2002; 179(1):15-20.
  3. Harirchi I, Karbakhsh M, Kashefi A, Momtahen AJ. Breast cancer in Iran: results of a multi-center study. Asian pacific journal of cancer prevention 2004; 5(1):24-7.
  4. Devolli-Disha E, Manxhuka-Kërliu S, Ymeri H, Kutllovci A. Comparative accuracy of mammography and ultrasound in women with breast symptoms according to age and breast density. Bosnian journal of basic medical sciences 2009; 9(2):131.
  5. Osako T, Iwase T, Takahashi K, Iijima K, Miyagi Y, Nishimura S, et al. Diagnostic mammography and ultrasonography for palpable and nonpalpable breast cancer in women aged 30 to 39 years. Breast cancer 2007; 14(3):255-9.
  6. Günther-Tritsch K, Ohlinger R, Bojahr BA. Diagnostic value of palpation and ultrasonography for diagnosing breast cancer recurrence after mastectomy–a comparison. Ultraschall in der Medizin-European Journal of Ultrasound 2009; 30(06):577-84.
  7. Berg WA, Blume JD, Cormack JB, Mendelson EB, Lehrer D, Böhm-Vélez M, et al. Combined screening with ultrasound and mammography vs mammography alone in women at elevated risk of breast cancer. Jama 2008; 299(18):2151-63.
  8. American Cancer Society. Cancer facts & figures 2014. American Cancer Society; 2014.
  9. Montazeri A, Sadighi J, Farzadi F, Maftoon F, Vahdaninia M, Ansari M, et al. Weight, height, body mass index and risk of breast cancer in postmenopausal women: a case-control study. BMC cancer 2008; 8:1-7.
  10. Lahmann PH, Hoffmann K, Allen N, Van Gils CH, Khaw KT, Tehard B, et al. Body size and breast cancer risk: findings from the European Prospective Investigation into Cancer and Nutrition (EPIC). International journal of cancer 2004; 111(5):762-71.
  11. López-Otín C, Diamandis EP. Breast and prostate cancer: an analysis of common epidemiological, genetic, and biochemical features. Endocrine reviews 1998; 19(4):365-96.
  12. Brunicardi F, Charles A, Danak KB, Timothy R, Dunn DL, Hunter J, et al. Schwartz’s Principles of surgery. 8nd New York: Mc Graw–Hill; 2005
  13. Fichtner I, Becker M, Zeisig R, Sommer A. In vivo models for endocrine-dependent breast carcinomas: special considerations of clinical relevance. European Journal of Cancer 2004; 40(6):845-51.
  14. Kopans DB, Swann CA, White G, McCarthy KA, Hall DA, Belmonte SJ, et al. Asymmetric breast tissue. Radiology 1989; 171(3):639-43.
  15. Hall JA, Murphy DC, Hall BR, Hall KA. Mammographic abnormalities and the detection of carcinoma of the breast. American journal of obstetrics and gynecology 1993; 168(6):1677-82.
  16. Knutzen AM, Gisvold JJ. Likelihood of malignant disease for various categories of mammographically detected, nonpalpable breast lesions. InMayo Clinic Proceedings 1993; 68(5):454-460.
  17. Jeffries DO, Adler DD. Mammographic detection of breast cancer in women under the age of 35. Investigative radiology 1990; 25(1):67-71.
  18. Skinner MA, Swain MA, Simmons RA, McCarty Jr KS, Sullivan DC, Iglehart JD. Nonpalpable breast lesions at biopsy. A detailed analysis of radiographic features. Annals of surgery 1988; 208(2):203.
  19. Dawson JS, Wilson AR. Short-term recall for ‘probably benign’mammographic lesions detected in a three yearly screening programme. Clinical radiology 1994; 49(6):391-5.
  20. Goedde TA, Frykberg ER, Crump JM, Lay SF, Turetsky DB, Linden SS. The impact of mammography on breast biopsy. The American Surgeon 1992; 58(11):661-6.
  21. Skaane P, Skjørten F. Ultrasonographic evaluation of invasive lobular carcinoma. Acta Radiologica 1999; 40(4):369-75.
  22. Goodman DN, Boutross-Tadross O, Jong RA. Mammographic features of pure mucinous carcinoma of the breast with pathological correlation. Canadian Association of Radiologists journal= Journal l'Association canadienne des radiologistes 1995; 46(4):296-301.
  23. Sung DW, Lim JW, Yoon Y, Kim YW, Lee JH, Cho KS. Primary breast lymphoma. Journal of Korean Medical Science 1993; 8(3):210-3.
  24. Crowe DJ, Helvie MA, Wilson TE. Breast infection: mammographic and sonographic findings with clinical correlation. Investigative radiology 1995; 30(10):582-7.
  25. Oh KK, Kim JH, Kook SH. Imaging of tuberculous disease involving breast. European radiology 1998; 8:1475-80.
  26. Venta LA, Wiley EL, Gabriel H, Adler YT. Imaging features of focal breast fibrosis: mammographic-pathologic correlation of noncalcified breast lesions. AJR. American journal of roentgenology 1999; 173(2):309-16.
  27. Piccoli CW, Feig SA, Palazzo JP. Developing asymmetric breast tissue. Radiology 1999; 211(1):111-7.
  28. Poulton TB, De Paredes ES, Baldwin M. Sclerosing lobular hyperplasia of the breast: imaging features in 15 cases. AJR. American journal of roentgenology 1995; 165(2):291-4.
  29. Zonderland HM, Michiels JJ, Ten Kate FJ. Case report: mammographic and sonographic demonstration of extramedullary haematopoiesis of the breast. Clinical radiology 1991; 44(1):64-5.
  30. Berkowitz JE, Gatewood OM, Gayler BW. Equivocal mammographic findings: evaluation with spot compression. Radiology 1989; 171(2):369-71.
  31. Baines CJ, Mcfarlane DV, Miller AB. The role of the reference radiologist; estimates of inter-observer agreement and potential delay in cancer detection in the national breast screening study. Investigative radiology 1990; 25(9):971-6.
  32. Wallis MG, Walsh MT, Lee JR. A review of false negative mammography in a symptomatic population. Clinical radiology 1991; 44(1):13-5.
  33. Mahboby A, Basirat Z. Clinical, Sonographical and mamographic findings in women with mastalgia. Journal of Ardabil University of Medical Sciences 2009; 9(2):111-8.
  34. Naghizadeh S, Mohebi P, Hadizadeh P. Mammography and ultrasound in women with breast pain, CBE, a comparative study of the results in Tabriz Improvement Hospital. Irainian journal of breast disease 2012;5(1): 54-64.
  35. Duijm LE, Groenewoud JH, Fracheboud J, De Koning HJ. Additional double reading of screening mammograms by radiologic technologists: impact on screening performance parameters. Journal of the National Cancer Institute 2007; 99(15):1162-70.
  36. Clegg-Lamptey JN, Edusa C, Ohene-Oti N, Tagoe JA. Breast cancer risk in patients with breast pain in Accra, Ghana. East African Medical Journal 2007; 84(5):215-8.
  37. Fakhrjou A, Montazery V, Mirzazadeh S, Shadravan S. Histological Diagnosis of One Hundred Painful Breast Masses. Medical Journal of Tabriz University of Medical Sciences 2011; 32(6):40-4.
  38. Kelemen LE, Pankratz VS, Sellers TA, Brandt KR, Wang A, Janney C, et al. Age-specific trends in mammographic density: the Minnesota Breast Cancer Family Study. American journal of epidemiology 2008; 167(9):1027-36.
  39. Park SY, Kim EK, Oh KK, Lee KS, Park BW. The role of sonography in patients with breast cancer presenting as an axillary mass. Korean journal of radiology 2002; 3(3):189-93.
  40. Shafighi S, Bayati A, Rafii M, Kalantari M. Determination of compliance of ultrasound with physical examination finding in diagnosis of breast Cancer. Iran surgery J 2007; 15(3):92-6.
  41. Adib V, Zare Z. Evaluation and follow-up mammogram in six months lesion probably benign breast. JMR 2004; 1(3):18-25.
  42. Gharekhanlo F, Torabian S, Kamrani S. Assesment of the role of supplementary ultrasound in the diagnosis of breast cancer. J Med Sci Hamedan 2010; 17(4):57-60.
  43. Aliromayi N, Fathi M, Mahmoodi S. Breast cancer screening and mammography findings in women referred to the radiology department of a medical center in Sanandaj Unity. J Breast Disease Iran 2010; 2(3-4):12-19.
  44. Shakouri Partovi P, Nami F. Evaluation of the mammographic findings in patients over 40 years of age with mammary disorders. Armaghane danesh 2004; 9(3):67-73.
  45. Shen SJ, Sun Q, Xu YL, Zhou YD, Guan JH, Mao F, et al. Comparative analysis of early diagnostic tools for breast cancer. Zhonghua zhong liu za zhi [Chinese journal of oncology] 2012; 34(11):877-80.
  46. Masroor I, Ahmed MN, Pasha S. To evaluate the role of sonography as an adjunct to mammography in women with dense breasts. Journal of the Pakistan Medical Association 2009; 59(5):298.
  47. Leung JW, Sickles EA. Developing asymmetry identified on mammography: correlation with imaging outcome and pathologic findings. American Journal of Roentgenology 2007; 188(3):667-75.
  48. Burhenne HJ, Burhenne LW, Goldberg F, Hislop TG, Worth AJ, Rebbeck PM, et al. Interval breast cancers in the Screening Mammography Program of British Columbia: analysis and classification. AJR. American journal of roentgenology 1994; 162(5):1067-71.
  49. Sina A, Jalili A, Abdi A, AGHA RR. Study of the mammographic findings and correlation of breast tumors with the pathological results In Imam Khomeini Hospital Urmia. J Urmia Univ Me Sci 2002; 13(3):213-219.
  50. Okello J, Kisembo H, Bugeza S, Galukande M. Breast cancer detection using sonography in women with mammographically dense breasts. BMC medical imaging 2014; 14(1):1-8.
  51. Adibi A, Golshahi M, Sirus M, Kazemi K. Breast cancer screening: Evidence of the effect of adjunct ultrasound screening in women with unilateral mammography-negative dense breasts. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences 2015; 20(3):228.
  52. Sickles EA. Mammographic features of 300 consecutive nonpalpable breast cancers. American Journal of Roentgenology 1986; 146(4):661-3.
  53. Melnikow J, Fenton JJ, Whitlock EP, Miglioretti DL, Weyrich MS, Thompson JH, et al. Supplemental screening for breast cancer in women with dense breasts: a systematic review for the US Preventive Services Task Force. Annals of internal medicine 2016; 164(4):268-78.
  54. Tworoger SS, Rice MS, Rosner BA, Feeney YB, Clevenger CV, Hankinson SE. Bioactive prolactin levels and risk of breast cancer: a nested case–control study. Cancer Epidemiology, Biomarkers & Prevention 2015; 24(1):73-80.
  55. Faupel-Badger JM, Sherman ME, Garcia-Closas M, Gaudet MM, Falk RT, Andaya A, et al. Prolactin serum levels and breast cancer: relationships with risk factors and tumour characteristics among pre-and postmenopausal women in a population-based case–control study from Poland. British journal of cancer 2010; 103(7):1097-102.
  56. Aliasgarzadeh A, Sanaat Z, Karimi Avval S, Niafar M, Agamohammadzadeh N. Thyroid Autoimmunity in Patients with Breast Cancer. Iranian Journal of Endocrinology and Metabolism 2011; 13(2):190-6.
  57. Kriege M, Brekelmans CT, Obdeijn IM, Boetes C, Zonderland HM, Muller SH, et al. Factors affecting sensitivity and specificity of screening mammography and MRI in women with an inherited risk for breast cancer. Breast cancer research and treatment 2006; 100:109-19.
  58. Banks E, Reeves G, Beral V, Bull D, Crossley B, Simmonds M, et al. Influence of personal characteristics of individual women on sensitivity and specificity of mammography in the Million Women Study: cohort study. Bmj 2004; 329(7464):477.
  59. Berg WA. Tailored supplemental screening for breast cancer: what now and what next?. American Journal of Roentgenology 2009; 192(2):390-9.
مجله زنان، مامایی و نازایی ایران
دوره 26، شماره 7
مهر 1402
صفحه 32-43

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