伴大汗腺分化浸润性乳腺癌的超声特征

Ultrasonographic features of invasive breast carcinoma with apocrine differentiation

目的:探讨伴大汗腺分化浸润性乳腺癌(invasive breast carcinoma with apocrine differentiation,BCAD)的超声特征。方法:回顾并分析14个BCAD病灶的临床及超声表现特点,总结其声像图特征。结果:14个BCAD病灶中,单纯性大汗腺癌(pure apocrine carcinoma,PAC)8个,混合性大汗腺癌(mixed apocrine carcinoma,MAC)6个,病灶多发生于外上象限(71.4%),且60.0%位于左乳外上象限。超声检查示BCAD可表现为实性低回声(64.3%)或囊实性回声(35.7%),其中50.0%的PAC为囊实性回声,而MAC以实性低回声为主(83.3%),PAC、MAC的形状多不规则(75.0%、83.3%),边缘均以成角为主(分别为62.5%、83.3%),多伴微钙化(分别为75.0%、50.0%),血供多为AdlerⅡ~Ⅲ级(分别为87.5%、66.7%)。BCAD的超声定性诊断与病理学检查符合率为78.6%。结论:BCAD发生的位置及声像图具有一定特殊性,但声像特征不典型,确诊仍需进一步行病理学活检。

Objective:To investigate the ultrasonographic features of invasive breast carcinoma with apocrine differentiation(BCAD).Methods:A total of 14 lesions of BCAD confirmed by pathological examination were selected to analyze the clinical and ultrasonographic features,and the sonographic characteristics were summarized.Results:Eight pure apocrine carcinomas(PACs)and six mixed apocrine carcinomas(MACs)were included in the 14 cases,and 71.4%cases occurred at outer upper quadrant and 60.0%on the left breast.Ultrasound examination showed that 64.3%lesions were solid hypoechoic and 35.7%showed complex echo,and 50.0%PACs were complex echo while 83.3%MACs showed solid hypoechoic.Most of PACs and MACs showed irregular shape(75.0%and 83.3%,respectively),angular protrusion of edge(62.5%and 83.3%,respectively),accompanied by calcification(75.0%and 50.0%,respectively),and blood AdlerⅡ-Ⅲgrade(87.5%and 66.7%,respectively).According to pathology results,the ultrasonic coincidence rate of BCAD was 78.6%.Conclusion:The sonographic findings and position of BCAD are certain particularity.Since sonography characteristic of BCAD is not obvious,the definitive diagnosis still requires pathological biopsy.