유방암 환자에서 수술 전 자기공명영상의 유용성: 유방초음파검사와 비교 연구 = Usefulness of preoperative breast MRI in breast cancer: Comparison with breast US

다국어 초록 (Multilingual Abstract)

Purpose: The purpose of this study was to evaluate the usefulness of preoperative breast MRI compared with breast US and pathologic finding in breast cancer patients
Materials and Methods: A total of 50 patients with breast cancer underwent surgery at our institute between October 2004 and August 2005. They were examined preoperatively with MRI and US. The maximum diameter and the number of the lesions on MRI and US were measured. These measurements were subsequently compared with the pathologic results. The results were divided into the equal, overestimated and underestimated groups. Changes of the therapeutic approach, based on MRI, were also evaluated.
Results: Breast cancer was correctly evaluated in 38 of 50 (76%) patients with MRI and in 28 of 50 (56%) patients with US; the cancer was overestimated in 7 of 50 (14%) patients with MRI and in 8 of 50 (16%) patients with US; the cancer was underestimated in 5 of 50 (10%) patients with MRI and in 14 of 50 (28%) patients with US. The therapeutic approach was changed in 11 of 50 (22%) patients, and all the cases underwent modified radical mastectomy. The therapeutic approach was correctly changed in 9 (18%) patients. Unnecessary wider excision was performed in 2 (4%) patients.
Conclusion: In conclusion, preoperative breast MRI may be a useful modality for preoperative evaluation, especially for the local staging of tumor and the treatment planning of patients with breast cancer.

국문 초록 (Abstract)

목적: 유방암 환자에서 수술 전 유방 자기공명영상과 유방초음파 결과를 병리 결과와 비교하여 종양 범위 측정의 정확도를 평가하고 수술 방법의 변화 여부를 조사하여 자기공명영상의 유용성을 알아보고자 하였다.
대상과 방법: 2004년 10월에서 2005년 8월까지 생검으로 유방암이 확진된 후 유방 자기공명영상을 시행한 54명의 환자 중 병리 결과와 비교할 수 있었던 50명의 환자를 대상으로 하였다. 유방 자기공명영상과 유방초음파를 분석하고 병리 결과를 표준으로 해서 병변의 개수와 최대 직경을 비교한 후 과대측정, 동일, 과소측정으로 분류하여 자기공명영상과 유방초음파의 정확도를 알아보았다. 또한, 자기공명영상 소견에 따른 수술적 치료의 변화 여부를 알아보았다.
결과: 총 50명 환자의 병리 결과에 따른 종양크기는 평균 2.2 cm(범위; 0.8-8.5 cm)이었다. 병변의 수는 1개인 경우가 30명, 2개인 경우가 10명, 3개인 경우가 1명, 4개 이상인 경우가 6명이었다. 종양의 크기와 개수에서 자기공명영상은 전체 50명 중 38명(76%)에서 병리 소견과 일치하였다. 일치하지 않는 경우는 7명(14%)에서 과대평가, 5명(10%)에서 과소평가되었다. 유방초음파에서는 50명 중 28명(56%)에서 병리 소견과 일치하였으며 과대평가는 8명(16%), 과소평가는 14명(28%)이었다. 자기공명영상의 결과에 의해 수술 치료 방법이 변한 경우는 11명(22%)이었고 모두 변형근치유방절제술을 시행받았다. 11명 중 적절한 수술 방법을 시행한 경우는 9명(18%)이고 나머지 2명(4%)은 자기공명영상에서 과대평가되었던 경우이다.
결론: 유방암 환자에서 수술 전 유방 자기공명영상은 종양의 범위를 정확하게 평가할 수 있고 유방암의 국소적 병기 결정과 치료 방침 결정을 위해 유용한 영상기법이다.

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