内容紹介
Summary
The patient was an 84-year-old woman. She had presented with a mass on her right breast. Mammography revealed an ill-defined mass. Handheld ultrasonography(HHUS)revealed a low echoic mass, 25 mm in diameter, on the AC area of her right breast. An automated breast volume scanner(ABUS)was not useful for detecting the lesion because the patient had dementia and restless body movements. A core needle biopsy for breast tumor led to a diagnosis of invasive ductal carcinoma, which was positive for estrogen and progesterone receptors, and negative for HER2/neu. The Ki-67-positive cell index was 70%. We examined her whole body and made a diagnosis of T2N0M0, StageⅡA. She underwent a muscle-preserving mastectomy plus sentinel lymph node biopsy. The pathological diagnosis from the resected surgical specimen was invasive ductal carcinoma, positive for estrogen and progesterone receptors, and negative for HER2/neu. The Ki-67-positive cell index was 70%. The surgical margins were negative for malignancy, and no metastasis was observed in the sentinel lymph node. She was given endocrine as adjuvant therapies. Three years after the surgery, she was well without metastases. Patients with dementia could not use ABUS. HHUS will be useful for these patients.
要旨
全自動乳房超音波画像診断装置(automated breast volume scanner: ABUS)を認知症の高齢者に使用し,検査に難渋したので報告する。症例は84歳,女性。介護施設に入所中である。入浴時に職員が右乳房腫瘍に気付き,当科を紹介・受診した。来院時,右AC領域に25 mmの腫瘤を触知した。マンモグラフィ検査ではspiculationを伴う腫瘤として描出された。従来型の超音波検査では同部に25 mmの境界不明瞭な低エコー腫瘤を認めた。検査施行時に体動は激しかったが,体動に合わせて良好な画像を得ることができた。ABUS(GE社製)による検査では乳房圧迫後の体動が激しく,良好な画像を得ることができなかったため家族の承諾を得て睡眠中に施行した。針生検で浸潤性乳管癌と診断した。胸筋温存乳房切除+センチネルリンパ節生検術を施行した。一定時間静止状態を維持できない症例には,従来型超音波機器のほうが良好な画像を得やすいものと考えられた。
目次
The patient was an 84-year-old woman. She had presented with a mass on her right breast. Mammography revealed an ill-defined mass. Handheld ultrasonography(HHUS)revealed a low echoic mass, 25 mm in diameter, on the AC area of her right breast. An automated breast volume scanner(ABUS)was not useful for detecting the lesion because the patient had dementia and restless body movements. A core needle biopsy for breast tumor led to a diagnosis of invasive ductal carcinoma, which was positive for estrogen and progesterone receptors, and negative for HER2/neu. The Ki-67-positive cell index was 70%. We examined her whole body and made a diagnosis of T2N0M0, StageⅡA. She underwent a muscle-preserving mastectomy plus sentinel lymph node biopsy. The pathological diagnosis from the resected surgical specimen was invasive ductal carcinoma, positive for estrogen and progesterone receptors, and negative for HER2/neu. The Ki-67-positive cell index was 70%. The surgical margins were negative for malignancy, and no metastasis was observed in the sentinel lymph node. She was given endocrine as adjuvant therapies. Three years after the surgery, she was well without metastases. Patients with dementia could not use ABUS. HHUS will be useful for these patients.
要旨
全自動乳房超音波画像診断装置(automated breast volume scanner: ABUS)を認知症の高齢者に使用し,検査に難渋したので報告する。症例は84歳,女性。介護施設に入所中である。入浴時に職員が右乳房腫瘍に気付き,当科を紹介・受診した。来院時,右AC領域に25 mmの腫瘤を触知した。マンモグラフィ検査ではspiculationを伴う腫瘤として描出された。従来型の超音波検査では同部に25 mmの境界不明瞭な低エコー腫瘤を認めた。検査施行時に体動は激しかったが,体動に合わせて良好な画像を得ることができた。ABUS(GE社製)による検査では乳房圧迫後の体動が激しく,良好な画像を得ることができなかったため家族の承諾を得て睡眠中に施行した。針生検で浸潤性乳管癌と診断した。胸筋温存乳房切除+センチネルリンパ節生検術を施行した。一定時間静止状態を維持できない症例には,従来型超音波機器のほうが良好な画像を得やすいものと考えられた。