全数字化乳腺摄影、三维定位在乳腺癌诊断中的应用

目的:探讨全数字化乳腺X线摄影、数字化三维立体定位术在乳腺癌普查、早期诊断中的应用价值.方法:回顾性分析行全数字化乳腺X线摄影检查1890例,全部病例均经全数字化X线摄影常规摄取CC位(头尾位)、MLO位(内外斜位)片.对常规摄片提示有可疑乳腺癌征象,而临床触诊阴性者行数字化三维立体定位,病灶导丝标记切检.结果:检出并手术、病理证实乳腺癌59例.临床触诊阳性(可触及肿块)者51例,病理类型为浸润性导管癌33例,浸润性小叶癌8例,黏液腺癌6例,髓样癌4例.临床触诊阴性(未触及肿块)者8例,病理类型为导管原位癌3例,导管浸润癌3例,小叶原位癌2例,在定位导丝下行病灶切除,切除标本摄片均确认属目标病灶.结论:全数字化乳腺X线摄影能较清晰显示乳腺癌的直接和间接X线征象,结合数字化三维立体定位,病灶导丝标记切检术,对早期乳腺癌及亚临床期(临床触诊阴性)乳腺癌有重要的诊断价值.

Routine Full-field Digital Mastography Combined with Three-Dimensional Digital Localization for Diagnosing Breast Cancer

Objective:To investigate the value of full-field digital X-ray mastography combined with three-dimensional digital localization in breast cancer survey and diagnosis.Methods:One thousand and eight hundred and ninety cases during March 2005 to Decenber 2006 were examined by full-field digital X-ray mastography on cranio-caual position (CC position) and middle-lateral oblique position (MLO position).Those cases with suspect breast cancer by routine film reading but negative clinical palpation were further performed three-dimensional digital localization and micro-biopsy under x-ray orientation.Results.Fifty-nine of 1890 cases were diagnosed with breast cancer and confirmed by pathology after tumor excision.Fifty-one cases with positive mass palpation comprised of infiltrative duct carcinoma (33 cases),infiltrative lobular carcinoma (8 cases),mucoid adenocarcinoma (6 cases),medullary carcinoma (4 cases).Eight cases with negative palpation were found with duct carcinoma in situ (3 cases),duct infiltrative carcinoma (3 cases) and lobular carcinoma in situ (2 cases).Conclusion:Full-field digital X-ray mastography can clearly show direct and indirect X-ray signs of breast cancer.When combine with three-dimension digital localization and biopsy,breast cancer can be easily diagnosed.It is very important especially for those sub-clinical patients with negative palpation and suspect mastography.