乳腺X线摄影对临床体检及超声检查阴性、X线摄影可疑病灶用外科干预的指导意义

目的：探讨乳腺影像报告及数据系统（BI-RADS）对临床体检及超声检查阴性、乳腺X线摄影可疑阳性的乳房病灶用外科干预的指导意义。方法：对乳腺X线摄影提示存在可疑病灶,而临床无法扪及明显肿块且超声检查阴性的病人,进行乳腺X线立体定位,作手术活检或真空辅助微创旋切活检,以明确可疑病灶的病理诊断。使用卡方检验或确切概率法检验,比较不同BI-RADS分类间恶性疾病发生率的差异;组间两两比较采用卡方分割法。结果：180例病灶中,BI-RADS分类属4A类者为92例,4B类者为64例,4C类者为24例。有23例病灶证实为恶性病变,其中2例（8.7%）为4A类,9例（39.1%）为4B类,12例（52.3%）为4C类。卡方检验发现,不同BI-RADS分类组之间,恶性病例的发生率有统计学差异（P〈0.001）;BI-RADS属4C组者恶性病例显著多于属4B组者（50.0%比14.1%,P=0.004）;BI-RADS属4B组者,恶性病例显著多于属4A组者（14.1%比2.2%,P〈0.001）。结论：对于乳腺X线摄影检查为唯一阳性结果的乳腺病灶,BI-RADS分类系统对是否应予外科干预有指导意义。BI-RADS属4A类病灶可行短期随访;属4B或4C类病灶需进一步作外科活检以明确诊断。

Role of BI-RADS in guiding surgical inter vention of non-palpable, ultrasound-negative and mammography-suspicious breast lesions

Objective To evaluate the role of Breast Imaging Reporting and Database System(BI-RADS) in guiding surgical intervention of non-palpable,ultrasound-negative and mammography-suspicious breast lesions.Methods Stereotactic breast biopsies,including excisional biopsies and vacuum assisted biopsies were conducted to determine the pathologic nature of those breast lesions only detected by mammography.Chi-square tests were used to compare the rates of malignant lesions in different BI-RADS groups.Results A total o...