全数字化乳腺X线摄影联合乳腺超声对老年乳腺癌的诊断价值

目的：探讨全数字化乳腺X线摄影（ FFDM）联合乳腺超声（ BUS）对老年乳腺癌的诊断价值。方法收集经组织病理学证实的107例老年乳腺癌以及27例乳腺良性病变（≥60岁），术前均行FFDM以及BUS检查。回顾性总结其影像表现，并与组织病理学结果对照，对比不同影像检查方法诊断老年乳腺癌的敏感度、特异度以及准确率等。结果老年乳腺癌以非特殊型浸润性癌Ⅱ级为主（64／107，59.8％），肿块常见（83／107），钙化出现率较低（21／107）。 FFDM诊断老年乳腺癌的敏感度91.6％、特异度70.4％、准确率87.3％，BUS检查的诊断敏感度81.3％、特异度77.8％、准确率80.6％， FFDM联合BUS检查的诊断敏感性、特异性以及准确率依次为95.3％、85.2％、93.3％，单独应用FFDM或BUS检查诊断老年乳腺癌的ROC曲线AUC值分别为0.810、0.795，联合应用FFDM与BUS检查诊断老年乳腺癌的ROC曲线AUC值最高，约为0.903。结论老年乳腺癌以肿块型常见，病理以非特殊型浸润性癌Ⅱ级为主。 FFDM联合BUS检查对老年乳腺癌的诊断效能优于单一的FFDM或BUS检查。

Diagnostic value of full-field digital mammography combined with breast ultrasound in senile breast cancer

Objective To investigate the diagnostic value of full -field digital mammography (FFDM) combined with breast ultrasound ( BUS) in senile breast cancer .Methods 107 cases of senile breast cancer and 27 cases of benign lesions (age≥60 years) were confirmed by pathology.All patients were examined with preoperative FFDM and BUS .The imaging features of senile breast cancer were analysed retrospectively , and compared with pathology results to evaluate the sensitivity , specificity and accuracy of different imaging methods .Results Grade II of invasive carcinoma of no special type was common in this group of patients with senile breast cancer (64/107,59.8%), and usually manifested as mass (83/107), but with low rate of calcificaiton (21/107).The sensitivity, specificity and accuracy for FFDM was 91.6%, 70.4%, 87.3%, respectively, and they were 81.3%, 77.8%, 80.6% for breast ultrasound; and 95.3%, 85.2%, 93.3%for combination of the two imaging modalities .ROC analysis showed that the average area under the curve ( AUC) was 0.810 for FFDM, 0.795 for BUS and 0.903 for combination of the two imaging methods .Conclusion Senile breast cancer is mainly presented as mass , and histological grading shows that Grade II of invasive carcinoma of no special type is the most common.The diagnostic value of FFDM combined with breast ultrasound in senile breast cancer is superior to sin -gle FFDM or BUS.