乳腺肿瘤性病变钼靶X线摄影结合临床触诊的价值

目的 评价钼靶X线摄影结合临床触诊对乳腺肿瘤性病变鉴别及定性诊断的价值,提高其诊断水平.方法 收集2008年4月至2011年7月在我院检查后接受手术治疗并经病理证实的167例乳腺病变资料,对其钼靶X线征象及临床触诊特点进行回顾性分析.结果 167乳腺病变中157例临床可触及肿块.乳腺良性病变者104例,钼靶X线多表现为圆形、椭圆形肿块,边界清楚,周边有或无透明“晕征”；触诊质韧或软,边界清楚,活动度好.乳腺癌63例,X线表现为肿块者58例；5例X线未见明显肿块,其中表现为结构紊乱者4例,恶性钙化者1例.肿块边缘不规则,分叶状或带毛刺,肿块伴恶性钙化、导管扩张、血管影增粗、皮肤增厚,为乳腺癌的较特异征象；结合触诊,肿块质硬,边界不清,活动度差,可与良性病变做出鉴别.结论 钼靶X线结合临床触诊对乳腺肿瘤的定性诊断起着重要的作用,可进一步提高诊断准确率.

Diagnostic value of digital mammography X-ray and clinical palpation in breast neoplasm

Objective To study the diagnostic value of mammography X-ray and clinical palpation in breast neoplasm. Methods The study enrolled 167 cases of patients with breast lesion whose diagnoses were confirmed by operation and pathology during April 2008 to July 2011, to analyze retrospectively the characteristics of X-ray image and clinical palpation in benign and malignant neoplasm of breast. Results The lump masses were found in 157 of 167 cases via clinical palpation, 104 benign lesions whose mammography features of benign breast neoplasm included round or ellipse shape,clear margins with or without halo sign, and were touched with tough or soft quality, smooth edge and good mobility. 63 cases of breast cancer included irregular masses in 58 cases, architectural distortion in 4 cases and needle-point like microcalcification in 1 case without mass. Breast cancers were compared with benign diseases of breast by studying some typical signs, including the masses with irregular margin or burr-like mass, and malignant calcification, dilated duct, skin thickening and abnormal vessels were special signs of breast cancers. The cancers were touched with hard quality,unclear edge and poor mobility,and all of these were different from benign breast diseases. Conclusion It is important to diagnose breast cancer accurately via mammography X-ray combined with clinical palpation.