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Journal of Medical Ultrasonics

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1988 - Vol.15

Vol.15 No.03

Original Article(原著)

(0256 - 0263)


Ultrasonographic Analysis of Inflammatory Breast Carcinoma

佐久間 浩1, 藤井 祐次1, 権藤 守男2, 霞 富士雄3

Hiroshi SAKUMA1, Yuji FUJII1, Morio GONDOH2, Fujio KASUMI3

1財団法人癌研究会附属病院超音波室, 2財団法人癌研究会附属病院内科, 3財団法人癌研究会附属病院外科

1Department of Ultrasound, Cancer Institute Hospital, 2Department of Internal Medicine, Cancer Institute Hospital, 3Department of Surgery, Cancer Institute Hospital

キーワード : Inflammatory breast carcinoma, Ultrasonography, Histology, Dermal lymphatic permeation

Twenty-nine cases of inflammatory breast carcinoma were admitted to Surgical Department of Cancer Institute Hospital, Tokyo, during 1982-1987. The rate among the whole 2,807 breast cancer patients during the same period was 1.0%. Dermal lymphatic permeation by cancer cells (s.l.y.) was observed in 25 cases (86.2%) and was absent in 4 (13.8%). In addition, there were 20 cases (0.7%) in which no inflammatory changes were observed despite of presence of s.l.y.
Mastectomy was done on 24 cases among 29, while 5 others were treated with irradiation and chemotherapy after tissue-sampling including the skin for histopathological evaluation, hormonereceptor assay and sensitivity test of anti-cancer drugs. The distribution of histological types was as follows; 2 papillotubular carcinomas (8.3%), one solid-tubular carcinoma (4.2%), 19 scirrhous carcinomas (79.2%) and 2 invasive lobular carcinomas (8.3%).
Ultrasonography (US) was done on 28 patients. The sensitivity rate to diagnose as inflammatory breast carcinoma had been 42% before 1983, and was raised to 94% after then. The rest were all diagnosed as malignant.
The main characteristics of US images was thickness of the skin which correlated with skin edema, and was observed in 86% of inflammatory breast carcinoma. But the degree of thickness was lower in inflammatory breast carcinoma without s.l.y.
Lowering of echo-level of the skin was frequently observed. In many cases tumor shadow was accompanied by rough borders and attenuation of posterior echoes, and in some cases, by comedo-like-pattern alone. Higher echo-levels or rough echoes in the subcutaneous fatty tissue were occasionally seen.