Correlación ecosonográfica e histopatológica en el diagnóstico de cáncer de mama
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2020
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
Antecedentes: El cáncer de mama es una patología de gran frecuencia. La resonancia magnética es el método de referencia para diagnóstico. Sin embargo, sus costos obligan el uso de métodos más baratos como la ecografía que tiene rendimiento diagnóstico variable.
Objetivos: Determinar la correlación de las características ecosonográfica e histopatológica en pacientes con sospecha de cáncer de mama.
Metodología: Se realizó un estudio transversal que incluyó 112 mujeres de 30 a 50 años atendidas en el hospital Teodoro Maldonado en Guayaquil-Ecuador entre 1-06-2017 y 31-05-2018 por solicitud de ecografía por nódulo mamario. Se seleccionaron aleatoriamente pacientes sin antecedentes de cáncer de mama, con estudio histopatológico de la lesión. Se excluyeron gestantes. Para las criterios de BI-RADS se consideró de alto riesgo categoría 4b-5; para el diagnóstico ecográfico el criterio del imagenólogo.
Resultados: La prevalencia de cáncer de mama fue del 85%, más frecuente el ductal (92,1%). El valor de los criterios ecográficos BI-RADS para diagnóstico de cáncer fue S: 60%, E: 64.71%, VPP: 90.48%, VPN: 22.45%, CPP 1,70, CPN 0,62. Para el informe con criterio ecográfico en relación a la apreciación de observador como lesión maligna fue S: 93.68%, E: 11.76 %; VPP: 85.58%; VPN: 25%; CPP 1.06; CPN 0,54.
Conclusiones: El rendimiento diagnóstico con BIRADS tiene un mejor desempeño diagnóstico que el criterio médico. En parte podría ser por la subjetividad del examen que implica experiencia.
Background: Breast cancer is a very frequent pathology. Magnetic resonance imaging is the gold standard for diagnosis. However, their costs force the use of cheaper methods such as ultrasound that has variable diagnostic performance. Objectives: To determine the correlation of the echo-sonographic and histopathological characteristics in patients with suspected breast cancer. Methodology: A cross-sectional study was conducted that included 112 women between the ages of 30 and 50 treated at the Teodoro Maldonado Hospital in Guayaquil-Ecuador between 06-06-2017 and 05-31-2018, by request for ultrasound imaging of the breast lump. Patients without a history of breast cancer were randomly selected, with a histopathological study of the lesion. Pregnant women were excluded. For the BI-RADS criteria, category 4b-5 was considered high risk; for the ultrasound diagnosis the criterion of the imaging specialist. Results: The prevalence of breast cancer was 85%, the most frequent was ductal cancer (92.1%). The value of the BI-RADS ultrasound criteria for cancer diagnosis was S: 60%, E: 64.71%, PPV: 90.48%, NPV: 22.45%, PPR: 1.70, NPR: 0.62. For the report with ultrasound criteria in relation to the observer's appreciation as a malignant lesion, it was S: 93.68%, E: 11.76%; PPV: 85.58%; NPV: 25%; PPR: 1.06; NPR: 0.54. Conclusions: The diagnostic performance with BIRADS has a better diagnostic performance than the medical criteria. In part it could be due to the subjectivity of the exam that involves experience.
Background: Breast cancer is a very frequent pathology. Magnetic resonance imaging is the gold standard for diagnosis. However, their costs force the use of cheaper methods such as ultrasound that has variable diagnostic performance. Objectives: To determine the correlation of the echo-sonographic and histopathological characteristics in patients with suspected breast cancer. Methodology: A cross-sectional study was conducted that included 112 women between the ages of 30 and 50 treated at the Teodoro Maldonado Hospital in Guayaquil-Ecuador between 06-06-2017 and 05-31-2018, by request for ultrasound imaging of the breast lump. Patients without a history of breast cancer were randomly selected, with a histopathological study of the lesion. Pregnant women were excluded. For the BI-RADS criteria, category 4b-5 was considered high risk; for the ultrasound diagnosis the criterion of the imaging specialist. Results: The prevalence of breast cancer was 85%, the most frequent was ductal cancer (92.1%). The value of the BI-RADS ultrasound criteria for cancer diagnosis was S: 60%, E: 64.71%, PPV: 90.48%, NPV: 22.45%, PPR: 1.70, NPR: 0.62. For the report with ultrasound criteria in relation to the observer's appreciation as a malignant lesion, it was S: 93.68%, E: 11.76%; PPV: 85.58%; NPV: 25%; PPR: 1.06; NPR: 0.54. Conclusions: The diagnostic performance with BIRADS has a better diagnostic performance than the medical criteria. In part it could be due to the subjectivity of the exam that involves experience.
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NEOPLASIAS DE LA MAMA, RESONANCIA MAGNETICA, ECOSONOGRAFIA, HOSPITAL DE ESPECIALIDADES DR. TEODORO MALDONADO CARBO, CANTON GUAYAQUIL, ECUADOR