Bildgebende Diagnostik des invasiv lobulären Mammakarzinoms

 

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Zusammenfassung

In der klinischen Untersuchung und Mammografie entzieht sich das invasiv lobuläre Karzinom häufig einer frühzeitigen Diagnose, sodass es oft erst bei fortgeschrittener Tumorgröße diagnostiziert werden kann. Die Sonografie als ergänzendes diagnostisches Verfahren vermag die Sensitivität im Nachweis eines invasiv lobulären Karzinoms zu erhöhen, weist aber sogar in der Hand eines erfahrenen Untersuchers Limitationen auf. Ebenso sind beide Untersuchungsmodalitäten gemeinsam im Staging eines histologisch diagnostizierten invasiv lobulären Karzinoms limitiert, da sie häufig zu einer Unterschätzung der Tumorgröße führen und eine Multifokalität oder Multizentrizität häufig nicht erkennen können. Die MR-Mammografie stellt derzeit die sensitivste diagnostische Modalität im Nachweis und Staging des invasiv lobulären Mammakarzinoms dar, weshalb sie in der aktuellen Stufe-3-Leitlinie im lokalen Staging des invasiv lobulären Karzinoms empfohlen wird.

Abstract

Early diagnosis of invasive lobular breast carcinoma by physical examination and mammography is often difficult. It is thus often diagnosed only at an advanced tumor stage. Sonography of the breast can increase the sensitivity for diagnosis of invasive lobular breast cancer, but this modality has its limitations even when performed by experienced investigators. The combination of mammography and sonography also has limitations, particularly with regard to the staging of the invasive lobular cancer, as tumor dimensions are often underestimated and multifocality or multicentricity often not recognized. At present, MR mammography is the most sensitive modality for the diagnosis and staging of invasive lobular breast cancer. It has therefore been recommended for local staging of invasive lobular carcinoma in the updated stage 3 guidelines for the early detection of breast cancer in Germany 2008.

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PD Dr. med. Elke Hauth

Institut für Klinische Radiologie
Referenzzentrum Mammografie
Universitätsklinikum Münster

Albert-Schweitzer-Straße 33

48149 Münster

Email: ehauth@t-online.de