TOMOGRAFİ VE MAMOGRAFİNİN KARŞILAŞTIRILMASI, BİLGİSAYARLI TOMOGRAFİDE MEME KANSERİNİN TANISAL ÖZELLİKLERİ Features of Breast Cancer on Computerized Tomography with the Comparison of Mammography to Tomography

OZET Amac: Bu calismanin amaci, meme kanserinin bilgisayarli tomografi (BT)’de tanisal ozelliklerini belirlemek ve meme kanserinin tomografi gorulebilirlik derecesini arastirmaktir. Gerec ve Yontem: Mayis 2010-Ocak 2016 tarihleri arasinda histopatolojik tanisi bulunan 1000 meme lezyonu degerlendirildi. Bu lezyonlarin 604 (% 60,4)'unde meme kanseri tanisi vardi. 604 meme kanseri olgusunun 161 (% 16.1)’inin mamografi ve toraks BT goruntuleri vardi. Calismaya dahil edilen bu 161 lezyonun BT ve mamografi (MG)’de lezyonlarin tanisal ozellikleri, gorulebilirlik oranlari, malign ek odak ve patolojik LAP varligi lezyonlarin tipi, boyutu ve lokalizasyonundan haberi olmayan iki radyolog tarafindan degerlendirildi. Bulgular: Lezyon boyutlari BT'de 7-110 (25.82) mm ve MG'de 6-92 (24.97) mm arasinda degismekteydi. BT ve MG'de kitle sekilleri ve konturleri buyuk oranda duzensiz idi. Iki goruntuleme yontemi arasinda istatistiksel olarak anlamli bir fark bulunmadi (p <0,001). Cerrahi patolojisi mevcut olan 133 hastanin 38'inde (% 28) tumorden ayri malign ek odak saptanmis olup, MG’de lezyonlarin 18'i (% 47), BT’de ise 32’si (% 84) tespit edildi. Cerrahi patolojide 133 hastanin 55'inde (%41) patolojik lenfadenopati (LAP) tespit edilmis olup MG’de 17 (% 30,1), BT’de ise 45 (% 81,9) patolojik LAP tespit edildi. Lezyonlarin yaklasik % 70'inde hem BT hem de MG'de oldukca iyi gorulebilirlik oranlari vardi. Iki gozlemci arasinda, gozlemciler arasi uyum anlamliydi. Sonuc: Tomografi kullanimindaki artistan dolayi, toraks BT’de meme dokusuna dikkat edilmesi ve meme kitlelerinin BT goruntuleme ozellikleri bilinmesi meme kanserinin erken teshisinde hayati oneme sahiptir. Anahtar Kelimeler: Bilgisayarli tomografi; Meme kanseri; Meme tomografisi ABSTRACT Aim: The main purpose of present study was to determine the diagnostic features of breast cancer on tomography (CT) and investigating the degree of tomographic visibility of breast cancer. Methods: A total amount of 1000 breast lesions with histopathologic diagnose evaluated between may 2010 and january 2016. 604 (60.4% ) of these lesions were diagnosed as breast cancer. Of these, 161 (16.1%) patients were evaluated with chest CT. These 161 patient included to study and lesion’s diagnostic features in mammography (MG) and CT, tomographic visibility rates, presence of malignant additional focus and pathological LAP were evaluated by two specialist blinded to lesions type, size and location, independently. Results: The lesion sizes ranged from 7 to 110 (25.82) mm in the CT and from 6 to 92 (24.97) mm in the MG. Most of the mass shapes and margins were irregular on CT and MG. No statistically significant difference was found between the two imaging modalities (p < 0.001). Of the 133 patients, 38 (28%) lesions had additional focuses on surgical pathology. MG could detect 18 (47%), CT could detect of these 32 (84%), additional focus. Of the 133 patients, 55 (41%) lesions had pathological LAP on surgical pathology. MG could detect 17 (30,1%), CT could detect of these 45 (81.9%), pathological LAP. Nearly 70% of the lesion was clearly identified on both CT and MG. There were significant interobserver reliability rates between the two observers. Conclusions: Due to the increase in the use of tomography, attention to the breasts in the study area and knowledge of CT imaging features of breast masses is of vital importance in the early diagnosis of breast cancer. Keywords: Computerized tomography; Breast cancer; Breast tomography