Meme kanserli olgularda operasyon öncesi dinamik kontrastlı meme manyetik rezonans görüntülemenin cerrahi planlamaya katkısı
Yükleniyor...
Dosyalar
Tarih
2012
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Meme kanserli olgularda, hastalığın evresinin doğru saptanması ve geri ye tümör dokusunun bırakılmaması uygun tedavi planlamasında belirleyici rol oynamaktadır. Meme manyetik rezonans görüntüleme (MRG), meme kanserli olgularda preoperatif cerrahi planlamasında kullanımı artan bir modalitedir. Bu çalışmanın amacı, prospektif olarak, meme kanserli kadınlarda, cerrahi önce si elde edilen meme MRG’nin cerrahi tedavi planlamaya katkısını araştırmaktır. Hastalar ve Yöntem: Çalışmaya 30 hasta dahil edildi. Lezyonlar Breast Imaging Reporting and Data System (BI-RADS) sınıflamasına göre 6 kategoride tanım landı. Veriler meme MRG incelemesi sonucu cerrahi planlamada yapılan değişik lik açısından analiz edildi. Bulgular: Hastaların primer tümör boyutları ile meme MRG ve histopatolojik değerlendirme ile ölçümlerinin yüksek düzeyde korelas yon gösterdiği saptandı (r:0.796, p:0.00). Meme MRG ile 11 hastada (%36) 14 ek lezyon saptandı. İki hasta hariç tüm olgularda histopatolojik değerlendirme so nuçlarının MRG bulguları ile uyumluluk gösterdiği görüldü. Tüm hasta grubunda meme MRG bulgularının cerrahi değişikliğe neden olduğu hasta oranı %17 idi. Mastektomi planlanan 16 olgunun 1’ine (%6.5) senkron kontrlateral meme kan seri nedeniyle ek meme koruyucu cerrahi (MKC) yapıldı. MKC planlanan olgula rın 4’ünde (%28) cerrahi plan mastektomi olarak değiştirildi. Hastaların 1’inde primer kanserin sınırları ve uzanımları, meme MRG ile daha net ortaya kondu ve MKC’den vazgeçilerek mastektomi uygulandı. Sonuç: Meme MRG bulgularının MKC planlanan hastalarda cerrahi planı de ğiştirebileceği klinik ve mamografik olarak saptanmış olup; preoperatif kont rastlı meme MRG’nin klinik ve mamografik saptanamayan okült invaziv ve no ninvaziv meme kanserlerinin yakalanmasında, tümör evrelemesinde, cerrahi planlamada rol oynadığı düşünülmektedir.
Objective: Accurate detection of tumor stage and no recurrent tumor af ter surgery play a determinant role in surgical planning in breast cancer patients. Breast magnetic resonance imaging (MRI) is being increasingly used in preoperative planning for breast cancer. The aim of this study is to evaluate the incremental value of preoperative breast MRI to surgical plan ning in women with diagnosis of breast cancer. Patients and methods: Thirty patients were enrolled in this study. Lesions were categorized according to the Breast Imaging Reporting and Data System (BI-RADS) classification. The data were analyzed according to the benefits and detriments of MRI findings and changes in surgical planning made according to MRI results. Results: There was a high correlation between primary tumor size and breast MRI– histopathologic measurements (r:0.796, p:0.00). Fourteen additional lesions were detected in 11 patients (%36) with MRI. MRI findings were concordant with histopathologic results except in 2 patients. In 17% of total patient group, the surgical approach changed according to breast MRI findings. An additional breast- conserving surgery (BCS) was applied in 1 of 16 (%6.5) patients with synchroneus contrlateral breast cancer whom were planned to undergo mastectomy. In 4 patients (28%) with BCS decision, the surgical ap proach was changed to mastectomy. In one patient, the border and extansion of the primary cancer was detected more clearly by MRI and the decision of BCS was changed to mastectomy. Conclusion: We found that MRI findings accurately guided the CBS planning. Preoperative contrast-enhanced breast MRI plays an important role in detec tion, staging and surgical planning in invasive and noninvasive cancers.
Objective: Accurate detection of tumor stage and no recurrent tumor af ter surgery play a determinant role in surgical planning in breast cancer patients. Breast magnetic resonance imaging (MRI) is being increasingly used in preoperative planning for breast cancer. The aim of this study is to evaluate the incremental value of preoperative breast MRI to surgical plan ning in women with diagnosis of breast cancer. Patients and methods: Thirty patients were enrolled in this study. Lesions were categorized according to the Breast Imaging Reporting and Data System (BI-RADS) classification. The data were analyzed according to the benefits and detriments of MRI findings and changes in surgical planning made according to MRI results. Results: There was a high correlation between primary tumor size and breast MRI– histopathologic measurements (r:0.796, p:0.00). Fourteen additional lesions were detected in 11 patients (%36) with MRI. MRI findings were concordant with histopathologic results except in 2 patients. In 17% of total patient group, the surgical approach changed according to breast MRI findings. An additional breast- conserving surgery (BCS) was applied in 1 of 16 (%6.5) patients with synchroneus contrlateral breast cancer whom were planned to undergo mastectomy. In 4 patients (28%) with BCS decision, the surgical ap proach was changed to mastectomy. In one patient, the border and extansion of the primary cancer was detected more clearly by MRI and the decision of BCS was changed to mastectomy. Conclusion: We found that MRI findings accurately guided the CBS planning. Preoperative contrast-enhanced breast MRI plays an important role in detec tion, staging and surgical planning in invasive and noninvasive cancers.
Açıklama
Anahtar Kelimeler
Tıbbi Araştırmalar Deneysel, Onkoloji, Radyoloji, Nükleer Tıp, Tıbbi Görüntüleme, Cerrahi
Kaynak
Meme Sağlığı Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
8
Sayı
1
