medvisМедицинская визуализацияMedical Visualization1607-07632408-9516RDS-Media Ltd.medvis-104Research ArticleПОВЕРХНОСТНЫЕ ОРГАНЫSUPERFICIAL ORGANSНовые подходы к диагностическому алгоритму отечно-инфильтративной формы рака молочной железы (обзор литературы)The Modern Approaches in Diagnostic Algorithm of Inflammatory Breast Cancer (The Literature Review)КолесникАнтонина ЮрьевнаKolesnikAntonina Yurievnak.antonina@mail.ruШершневаМария АндреевнаSherhnevaMaria Andreevnanoemail@neicon.ruМескихЕлена ВалерьевнаMeskihElena Valerievnanoemail@neicon.ruЧхиквадзеВладимир ДавыдовичChkhikvadzeVladimir Davidovichnoemail@neicon.ruНудновНиколай ВасильевичNudnovNikolai Vasilyevichnoemail@neicon.ruФГБУ “Российский научный центр рентгенорадиологии” Министерства здравоохранения РоссииРоссияRussian Scientific Center of RoentgenoradiologyRussian Federation20142810201405124129Copyright © Колесник А.Ю., Шершнева М.А., Меских Е.В., Чхиквадзе В.Д., Нуднов Н.В., 20142014Колесник А.Ю., Шершнева М.А., Меских Е.В., Чхиквадзе В.Д., Нуднов Н.В.Kolesnik A.Y., Sherhneva M.A., Meskih E.V., Chkhikvadze V.D., Nudnov N.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://medvis.rdsmedia.ru/jour/article/view/104

Отечно-инфильтративный рак молочной железы (ОИРМЖ) характеризуется агрессивным течением и высоким метастатическим потенциалом, поэтому своевременная диагностика влияет на исходы лечения. Основой для лучевой диагностики отечного РМЖ являются методы стандартной визуализации - маммография и УЗИ, а в качестве дополнительного используется МРТ Кроме того, на современном этапе развития новых диагностических технологий особую роль играют методы молекулярной визуализации - позитронно-эмиссионная томография/компьютерная томография (ПЭТ/КТ) и однофотонная эмиссионная компьютерная томография (ОФЭКТ). УЗИ является основным высокочувствительным методом, позволяющим в условиях любой клиники выявить опухолевый компонент при подозрении на ОИРМЖ в 93% случаев, что определяет возможность для морфологического установления диагноза. Маммография остается наименее чувствительным методом для диагностики ОИРМЖ, так как опухолевый узел на фоне отека тканей выявить затруднительно (16-80% в зависимости от методики маммографии), однако метод остается обязательным. МРТ позволяет выявить и топировать опухолевые изменения в молочной железе на фоне отека тканей практически у всех пациентов с ОИРМЖ. ПЭТ/КТ при ОИРМЖ является уточняющим исследованием для оценки распространенности опухолевого процесса, в том числе и в молочной железе. Роль ОФЭКТ в диагностике отечного РМЖ еще предстоит уста новить. Диагностический алгоритм при ОИРМЖ должен объединять все вышеуказанные методы исследования с целью получения наиболее полной картины заболевания, что чрезвычайно важно для планирования лечения.

Inflammatory breast cancer (IBC) is characterized by an aggressive course and high metastatic potential, therefore timely diagnosis affects outcome of the treatment. In the basis of instrumental diagnosis of IBC, standard imaging methods include - mammography and ultrasonography (USG) additional test and modern techniques such as magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT) can also be used. Ultrasound is the most highly sensitive technique that allows in terms of any clinic to identify tumor component in suspected IBC in 93% of cases, and determines the possibility for morphological diagnosis. Mammography is the least sensitive method for diagnosing IBC as tumor tissue on the background of tissue edema are difficult to identify (16-80%, depending on the method of mammography), but the method is still required. MRI allows to defect and pinpoint the tumor changes of the breast tissue in the presence of tissue edema in almost all of the patient with IBC. PET/CT during IBC remains the most accurate in staging the tumor process, and the significance of the method includes a visual ization of the tumor in the breast itself. The use of Single-Photon Emission Computed Tomography in the diagnosis of IBC remains to be established. In the diagnostic algorithm of IBC, combination of all the above methods of research should be used, in order to obtain the most complete picture of the disease, which is extremely important in treatment planning.

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The authors declare that there are no conflicts of interest present.