Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Upgraded Malignancy from High-Risk and Borderline Breast Lesions: Immunohistochemical and Clinical Characteristics

고위험 및 경계성 유방 병변에서 업그레이드된 악성 종양: 면역조직화학적 및 임상적 특징

  • Park, Borim (Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kang, Bong Joo (Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Baek, Ji Eun (Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kim, Sung Hun (Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Lee, Hyun Sil (Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
  • 박보림 (가톨릭대학교 의과대학 인천성모병원 영상의학과) ;
  • 강봉주 (가톨릭대학교 의과대학 서울성모병원 영상의학과) ;
  • 백지은 (가톨릭대학교 의과대학 서울성모병원 영상의학과) ;
  • 김성헌 (가톨릭대학교 의과대학 서울성모병원 영상의학과) ;
  • 이현실 (가톨릭대학교 의과대학 서울성모병원 영상의학과)
  • Received : 2017.04.24
  • Accepted : 2017.08.18
  • Published : 2018.01.01
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Abstract

Purpose: The purpose of this study was to investigate the immune-histochemical characteristics of upgraded malignancy from high-risk and borderline breast lesions, and to correlate the upgrade rates with clinical findings. Materials and Methods: We scrutinized image-guided biopsy records retrospectively, and included all women afflicted with high-risk and borderline breast lesions during the period, 2011 to 2015, inclusive. A total of 340 high-risk and borderline lesions were identified by the pathologist in biopsy samples and thereafter, surgical excision and/or image follow-up for at least 24 months was performed. We compared the clinical emanating from both high-risk and borderline lesions, and with and without cancer upgrade. In the instances of lesions with cancer upgrade, histologic and immuohistochemical reviews were performed. Results: Of the 340 high-risk or borderline lesions, 18.8% (64/340) were upgraded. The upgrade rates were higher in patients of more advanced age, larger body habitus and afflicted with atypical ductal hyperplasia rather than with other pathology (p < 0.05). In the lesions with cancer upgrade (n = 64), there was no lymph node metastasis. The estrogen receptor-positive (93.8%), progesterone receptor-positive (87.5%), human epidermal growth factor receptor type 2-negative (90.6%), Ki-67-negative (82.8%), and Luminal A (76.6%) types were seen more frequently. Conclusion: Most upgraded malignancies arising from high-risk and borderline breast lesions were found to be Luminal A-type with good prognostic factors, and the upgrade rates correlated with clinical characteristics.

목적: 이 연구의 목적은 고위험 및 경계성 유방 병변에서 업그레이드된 악성 종양의 면역조직화학적 특성을 조사하고 임상 소견과 암으로의 업그레이드율의 연관성을 알아보는 데 있다. 대상과 방법: 저자들은 영상유도하 생검 기록을 후향적으로 검토했으며 2011년부터 2015년까지 고위험과 경계성 유방 병변이 있는 모든 여성을 대상으로 하였다. 생검 샘플에서 병리학자에 의해 총 340개의 고위험 및 경계성 병변이 확인되었으며, 수술적 절제 혹은 24개월 이상 추적 검사가 시행되었다. 고위험 및 경계성 병변이 암으로 업그레이드된 경우와 아닌 경우의 임상 소견을 비교하였다. 암으로 업그레이드된 경우에 대하여, 병리조직학적 및 면역조직화학적 검사를 시행하였다. 결과: 340예의 고위험 또는 경계성 병변 중, 18.8%(64/340)가 암으로 업그레이드되었다. 업그레이드율은 고령의 환자, 크기가 큰 병변에서 더 높았고, 다른 병리학적 유형보다 atypical ductal hyperplasia에서 더 높았다(p < 0.05). 업그레이드 된 악성 종양(n = 64)에서는 림프절 전이가 없었다. Estrogen receptor 양성(93.8%), progesterone receptor 양성(87.5%), human epidermal growth factor receptor type 2 음성(90.6%), Ki-67 음성(82.8%), Luminal A (76.6%)형이 가장 흔하였다. 결론: 고위험 및 경계성 유방 병변에서 업그레이드된 악성 종양은 주로 Luminal A 면역조직화학형과 좋은 예후 인자를 가지며 업그레이드율은 임상 특성과 관련이 있다.

Keywords

Acknowledgement

Supported by : Ministry of Health & Welfare

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