Correlación imageno-histopatológica en el diagnóstico de carcinoma lobulillar infiltrante de mama
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2021
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
El carcinoma lobulillar invasivo se caracteriza por un patrón de crecimiento
infiltrativo y discresivo, que dificulta la evaluación precisa tanto clínica como
mediante estudios de imagen. A pesar de la incidencia y las tasas de recurrencia del
cáncer de mama, actualmente no hay instrumentos de diagnóstico específicos para
predecir qué casos se desarrollarán en carcinoma lobulillar infiltrante de mama.
Objetivo: Determinar la correlación imageno-histopatológica en el diagnóstico de
carcinoma lobulillar infiltrante de mama. Metodología: Estudio de enfoque
cuantitativo, observacional, analítico, retrospectivo y transversal. La población está
constituida por pacientes con diagnóstico histológico de cáncer lobulillar de mama
captados en el periodo del 1 de mayo del 2016 al 31 de diciembre del 2019 en el
Instituto Oncológico Nacional “Dr. Juan Tanca Marengo”. Resultados: Se reporta
1,5% de casos confirmados de carcinoma lobulillar infiltrante de mama. Predominó
el grupo de 40-60 años (52,5%), edad media de 58,47 ± 12,49, más afectación de la
mama izquierda (52,5%), todos presentaron masa palpable (100%). El 62,5% fue
de grado histológico medio. Los hallazgos más frecuentes de mamografía fueron
las calcificaciones (15%) y la asimetría mamaria (52,5%), retracción cutánea
(52,5%) y con BI-RADS 4B el 70%. Por ultrasonografía el nódulo mamario (55%),
de márgenes espiculados (37,5%) y lobulados (37,5%) con orientación paralela
fueron los más frecuentes (52,5%). Según la clasificación BI-RADS, el 45% de las
pacientes de estudio se clasificaron como tipo 4B por ecografía. Conclusión: Existe
buena concordancia diagnóstica entre los hallazgos de mamografía y
ultrasonografía con los resultados de histopatología.
Invasive lobular carcinoma is characterized by an infiltrative and discressive growth pattern, which makes accurate evaluation difficult both clinically and by imaging studies. Despite the incidence and recurrence rates of breast cancer, there are currently no specific diagnostic tools to predict which cases will develop into infiltrating lobular carcinoma of the breast. Objective: To determine the imagenohistopathological correlation in the diagnosis of infiltrating lobular carcinoma of the breast. Methodology: Study with a quantitative, observational, analytical, retrospective and cross-sectional approach. The population is made up of patients with histological diagnosis of lobular breast cancer captured in the period from May 1, 2016 to December 31, 2019 at the National Oncological Institute “Dr. Juan Tanca Marengo”. Results: 1.5% of confirmed cases of infiltrating lobular carcinoma of the breast are reported. The 40–60-year-old group (52.5%) predominated, mean age 58.47 ± 12.49, plus left breast involvement (52.5%), all presented palpable mass (100%). 62.5% were of medium histological grade. The most frequent findings on mammography were calcifications (15%) and breast asymmetry (52.5%), skin retraction (52.5%) and with BI-RADS 4B 70%. By ultrasonography, the mammary nodule (55%), spiculate margins (37.5%) and lobulated (37.5%) with parallel orientation were the most frequent (52.5%). According to the BI-RADS classification, 45% of the study patients were classified as type 4B by ultrasound. Conclusion: There is good diagnostic agreement between the findings of mammography and ultrasonography with the results of histopathology
Invasive lobular carcinoma is characterized by an infiltrative and discressive growth pattern, which makes accurate evaluation difficult both clinically and by imaging studies. Despite the incidence and recurrence rates of breast cancer, there are currently no specific diagnostic tools to predict which cases will develop into infiltrating lobular carcinoma of the breast. Objective: To determine the imagenohistopathological correlation in the diagnosis of infiltrating lobular carcinoma of the breast. Methodology: Study with a quantitative, observational, analytical, retrospective and cross-sectional approach. The population is made up of patients with histological diagnosis of lobular breast cancer captured in the period from May 1, 2016 to December 31, 2019 at the National Oncological Institute “Dr. Juan Tanca Marengo”. Results: 1.5% of confirmed cases of infiltrating lobular carcinoma of the breast are reported. The 40–60-year-old group (52.5%) predominated, mean age 58.47 ± 12.49, plus left breast involvement (52.5%), all presented palpable mass (100%). 62.5% were of medium histological grade. The most frequent findings on mammography were calcifications (15%) and breast asymmetry (52.5%), skin retraction (52.5%) and with BI-RADS 4B 70%. By ultrasonography, the mammary nodule (55%), spiculate margins (37.5%) and lobulated (37.5%) with parallel orientation were the most frequent (52.5%). According to the BI-RADS classification, 45% of the study patients were classified as type 4B by ultrasound. Conclusion: There is good diagnostic agreement between the findings of mammography and ultrasonography with the results of histopathology
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Neoplasias de la mama, Resonancia magnetica, Ultrasonido, Mamografía, Hospital Solca de Guayaquil, Cantón Guayaquil, Ecuador