数字化乳腺X线摄影在隐性乳癌的诊断价值

目的 评价数字化乳腺X线摄影在隐性乳癌的诊断价值.方法 分析我院2005年5月-2007年5月门诊发现的43例经病理证实的临床上未触及肿块乳癌(隐性乳癌).全部病例均采用全数字化乳腺摄影机检查,常规采用轴位(CC位),侧斜位(MLO位),必要时作局部病灶加压放大拍片.术前均行金属丝定位.结果 X线呈现单纯钙化18例,其中癌前病变3例,导管原位癌5例,浸润性导管癌10例;微结节或致密影伴钙化9例,其中癌前病变1例,导管原位癌5例,浸润性导管癌3例;呈现不对称性致密影7例,2例为小叶原位癌,5例为浸润性导管癌;微结节伴浅分叶或毛刺6例,其中2例为导管原位癌,4例为浸润性导管癌;结构紊乱3例,均为浸润性导管癌.结论 数字化乳腺X线摄影对未触及肿块的隐性乳癌的敏感性较高,开展保乳手术、提高生存质量及生存率、降低病死率等具有重大价值.

Evaluation of digital mammography in the diagnosis of nonpalpable breast cancer

Objective To evaluate the full-field digital mammography in the diagnosis of nonpalpable breast cancer. Methods 43 cases of nonpalpable tumor on digital mammogram were found in physical examination, All were verified by pathological examination.Routine positions of Full-field digital mammography were used in all patients including the craniocaudal projection(CC) and the mediolateral oblique projection(MLO), spot compression and magnification was performed when it was necessary. X-ray guided wire localization was conducted before operation. Results Microcalcifications were found on digital mammogram in 18 cases,3of these was disease before cancer,5 were ductal carcinoma in situ,10 were infiltrating ductal carcinoma; Micronodule or local hyperdensity on mammogram with calcification was found in 9 cases,1 was disease before cancer and 5 were lobubar carcinoma in situ ,3 were DCIS;Of 7 cases with asymmetrical increase of local density on mammogram,2 was lobubar carcinoma in situ, 5 were infiltrating ductal carcinoma; Multilobular small nodes was found in 6 cases,2 was DCIS,4 were infiltrating ductal carcinoma; Architectural distortion was found in 3 case,pathological examination were infiltrating ductal carcinoma. Conclusion It is high sensitivity of full-field digital mammography in diagnosing nonpalpable breast cancer,improving life quality and subsistence rate,decreasing mortality rate and performing partial breast operation.