磁共振成像测量肿瘤/乳腺体积比在乳腺癌手术治疗中的应用

Application of tumor/breast volume ratio measured by magnetic resonance imaging in surgical treatment of breast cancer

目的:研究磁共振成像(magnetic resonance imaging,MRI)测量的肿瘤/乳腺体积比与乳腺癌患者手术方式之间的相关性。方法:采用随机数法随机收集行保乳术的患者30例为研究组,行改良根治术的患者30例为对照组。其中单发肿块性乳腺癌58例,多发肿块性乳腺癌2例。所有患者经常规检查、外科医师评估及患者意愿综合考虑,再选择行保乳术或改良根治术。两组中各有20例患者术前未接受新辅助化疗,10例患者术前接受了新辅助化疗。所有患者术前均行乳腺MRI检查,回顾性计算其肿瘤/乳腺体积比,并比较两组患者肿瘤/乳腺体积比之间的差异。结果:研究组中仅有1例(3.33%)患者切缘阳性,改行肿块扩大切除术。研究组和对照组所有患者肿瘤/乳腺体积比的平均值分别为4.35%、9.65%(P=0.003)。两组术前未行新辅助化疗患者的肿瘤/乳腺体积比平均值分别为5.32%、10.18%(P=0.027)。两组术前行新辅助化疗患者的肿瘤/乳腺体积比平均值分别为2.43%、8.58%(P=0.07)。结论:从乳腺MRI数据中测量的肿瘤/乳腺体积比与新诊断乳腺癌患者手术方式的选择有相关性,是确定新诊断乳腺癌患者最适手术类型的一个有效评估方法,但其对术前行新辅助化疗患者手术方式的选择并未体现出有效的应用价值,在日常工作中应根据实际情况综合评估。

Objective: To investigate the correlation between tumor/breast volume ratios measured by magnetic resonance imaging (MRI) and the surgical methods of breast cancer patients.Methods: Randomly collected 30 patients with breast conserving surgery as the study group and 30 patients undergoing modified radical mastectomy as the control group.There were 58 cases of single breast cancer and 2 cases of multiple breast cancer.All patients were selected for breast conserving or modified radical resection after a combination of routine examination,surgeon evaluation,and patient wishes.In each of the two groups,20 patients did not receive neoadjuvant chemotherapy before surgery and 10 patients received neoadjuvant chemotherapy before surgery.All patients underwent MRI examination before operation.Their tumor/mammary volume ratio was calculated retrospectively,and the difference of tumor/breast volume ratio was compared between the two groups.Results: In the study group,only 1 patient (3.33%) had positive incisal margin and underwent augmentation mass resection.The mean tumor/breast volume ratio of all patients in the study group and the control group was 4.35% and 9.65%(P=0.003).The average tumor/breast volume ratio of the two groups without preoperative neoadjuvant chemotherapy was 5.32% and 10.18%(P=0.027).The average tumor/breast volume ratios of preoperative neoadjuvant chemotherapy patients in the two groups were respectively 2.43% and 8.58%(P=0.07).Conclusion: The tumor/breast volume ratio measured from breast MRI data is related to the selection of surgical methods for newly diagnosed breast cancer patients,and it is an effective evaluation method to determine the optimal operation type of newly diagnosed breast cancer patients.However,the selection of surgical methods for patients undergoing neoadjuvant chemotherapy before surgery has not shown effective application value.In daily work,comprehensive assessment should be based on actual conditions.