26例影像学低估的乳腺癌的临床分析

目的 分析乳腺癌被影像学低估的临床资料,比较影像学及病理学特点,总结易被低估的原因.方法 回顾性分析26例术前B超及钼靶BI-RADS分级≤3级,术后病理为乳腺癌的临床、影像学及病理学资料.并与同期的1224例乳腺癌临床及病理学资料做比较.结果 26例被低估的乳腺癌,均为早期人表皮生长因子受体（human epidermal growth factor receptor-2,HER2）阴性乳腺癌,只有1例有淋巴结转移,26％为特殊类型乳腺癌.钼靶上均表现为腺体中量型或多量型,在B超上表现不典型或典型的良性表现.结论 被影像学低估的乳腺癌年龄小、分期早、分化好、恶性程度低,钼靶不易发现肿块,B超表现不典型.在临床工作中应仔细分析B超及钼靶图像,联合其他检查方法,降低漏诊率.

Clinical analysis on 26 cases of imaging understated breast cancer

Objective To analyze the clinical data,radiological and pathological features of breast cancer which were understated by image,and summarize the causes.Methods The clinical features,radiological features and pathological data of 26 cases of breast cancer were retrospectively analyzed.The preoperative ultrasound and mammography BI-RADS grades of these 26 cases were both ≤ 3,and they were confirmed to be breast cancer by pathology.The clinical and pathological data of 1224 cases of breast cancer in the same period were compared.Results For the 26 cases,100％ were early breast cancer,100％ were HER2 negative breast cancer,and only 1 case had lymph node metastasis.26％ were special type of breast cancer.Mammography showed glandular multi type,and ultrasound showed atypical or typical benign features.Conclusions Breast cancer understated by image shows features of young age,early stage,well differentiated,low malignant degree,not easy to be visualized by mammography,and their ultrasound features are usually atypical.In clinical setting,analysis of the ultrasound and mammography images should be combined with other examination,to decrease misdiagnosis rate.