When can i avoid to biopsy a us-detected breast lesion ? - 29/01/10
Résumé |
Objectifs |
Distinguish complicated and complex cystic lesions. Discuss criteria for probably benign findings and their management. Discuss the current and future rôle of elastography in biopsy avoidance.
Messages à retenir |
Complicated cysts and clustered microcysts can be dismissed as benign or probably benign. Complex cystic masses, including those with thick (> 0,5 mm) septations, thick wall, intracystic mass, or cystic and solid components, merit biopsy, with 23% proving malignant.
Specifie criteria have been validated to allow follow-up rather than biopsy of many incidental masses seen on sonography.
Résumé |
Criteria to distinguish sonographically benign solid lesions from malignancies were first proposed by Stavros et al. Cysts and complicated cysts are quite common, seen in 30% of women in the ACRIN study. These can usually be dismissed as benign findings when multiple and bilatéral. In the ACRIN 6666 protocol, we considered the following benign or probably benign: oval, circumscribed hypoechoic or isoechoic masses, probable complicated cyst, hyperechoic masses suggestive of fat necrosis, clustered microcysts, probably artifactual shadowing, and post-surgical scar. We achieved < 2% rate of malignancy among lesions followed. Elastography may help avoid unnecessary aspiration or follow-up of complicated cysts, and this will be discussed.
Le texte complet de cet article est disponible en PDF.Mots clés : Sein, radiologie interventionnelle, Echographie, Biopsie
Vol 90 - N° 10
P. 1226 - octobre 2009 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.