乳腺X线检查在乳腺癌筛查中的应用分析

目的探讨乳腺X线检查对早期乳腺癌检出的意义,为今后筛查工作积累经验.方法对本县7752名女性乳腺癌X线筛查的结果,进行回顾性分析.结果参检的7752名女性中共发现乳腺癌18例.X线初检出16例,2例漏诊病灶被CDFI(彩色多普勒超声)发现,后经回顾性读片,X线予以正确诊断.结论针对中国女性乳腺的特点,从经济实用出发,在乳腺癌筛查中,采用体格检查+X线+CDFI的模式,对我国妇女乳腺癌的检出更有价值.     

乳腺钼靶X线与乳腺超声检查对乳腺癌早期筛查价值分析

目的探讨乳腺钼靶X线与乳腺超声检查对乳腺癌早期筛查的实际价值。方法选取2016年1月至2017年9月就诊于本院高度疑似乳腺癌患者共120例作为研究对象,所有患者分别行乳腺钼靶X线检查和乳腺超声检查,以最终病理检查结果为"金标准",分析两种检查方式对乳腺癌早期筛查的准确性。结果乳腺钼靶X线诊断准确率明显高于乳腺超声检查诊断准确率(P0.05)。结论乳腺钼靶X线应用于乳腺癌早期筛查准确率较高,适用范围广,安全性高,值得推广应用。     

新乡市城镇妇女乳腺癌筛查临床分析

目的对新乡市城镇妇女乳腺癌的发病情况进行筛查,以达到早期发现、早期诊断及早期治疗,降低新乡市城镇妇女乳腺癌的病死率。方法由固定的专业医务人员采用临床乳腺检查进行初筛,按年龄分层选择性乳腺超声检查及乳腺X线检查的乳腺癌筛查方案,对9048名新乡市城镇适龄妇女进行乳腺癌筛查。结果 9048名妇女共检出乳腺癌15例,检出率为165.78/10万(15/9048),其中Ⅰ期9例,Ⅱ期4例,Ⅲ期2例。乳腺临床检查中发现乳腺腺体结节样增厚2738例,乳腺肿块389例,病理性溢液53例,占筛查人群的35.14%(3180/9048),各年龄段乳腺异常情况的差异有统计学意义。结论开展乳腺癌筛查对新乡市城镇妇女乳腺癌的早期发现有重要意义。     

万例妇女乳腺癌筛查结果分析

目的 探讨适龄妇女早期发现、早期诊断乳腺癌的筛查方法.方法 行乳腺临床体检、乳腺钼靶X线摄片和超声检查相结合的筛查方法对适龄妇女进行体检,并以组织病理学检查为诊断依据.结果 红塔区16个社区35～69岁一万例适龄妇女接受筛查,检出乳腺疾病24例,确诊乳腺癌5例,乳腺癌发病率为50/10万.结论 乳腺癌筛查方法安全、有效、经济,并能早期发现、早期诊断、早期治疗,提高患者远期生存率,降低死亡率,值得推广应用.     

钼靶X线在乳腺癌筛查中的应用

目的探讨乳腺X线摄片在乳腺癌筛查中的应用。方法对1 200名乳腺癌筛查者均行乳腺x线摄片检查。结果采用BI-RADS分类法,1 200名乳腺癌筛查者中,脂肪型216例,占18%;少腺体型396例,占33%;多腺体型480例,占40%;致密型108例,占9%。0级32例,占2.67%;1级184例,占15.33%;2级636例,占53%;3级324例,占27%;4级18例,占1.5%;5级6例,占0.5%。乳腺X线摄片可疑乳腺癌20例,术后病理诊断10例为乳腺癌,其中4例为早期乳腺癌,占40%(4/10)。结论通过乳腺X线摄片在正常人群中行乳腺癌的筛查,有助于发现早期乳腺癌,为临床早期治疗提供依据。     

请您收藏——乳腺癌的筛查建议

乳腺癌是女性最常见的恶性肿瘤。乳腺癌的预后取决于疾病分期,在早期乳腺癌中导管原位癌的治愈率可达到95%以上,并且可以获得更多保留乳房的机会。因此,早期发现和治疗非常重要。乳腺癌筛查的手段主要有两种:(1)体格检查,由医生对被检查者的乳房和腋窝淋巴结进行触诊;(2)乳腺钼靶(乳腺钼靶X线摄影检查)。此外,超声等也可作为辅助检查方法。其中钼靶X线检查是最经典、证据最充分的检查手段,不过这种筛查方法主要适用于40岁以上女     

触诊阴性乳腺病灶56例定位活检诊断体会

近年来,随着乳腺超声和X线摄片作为乳腺疾病筛查手段的开展,临床不能触及的乳腺微小病灶（NPBL）越来越多地被检出;由于NPBL中约20%~30%为早期乳腺癌,因而在乳腺超声或X线摄片定位下开展NPBL活检,对于乳腺癌的早发现、早诊断、早治疗具有重要意义。     

乳腺X线摄影的方法与技巧

<正>近年来,乳腺癌发病率有上升趋势,已成为严重威胁妇女生命和健康的恶性肿瘤之一。虽然磁共振成像(MRI)检查能够提高乳腺癌影像诊断的敏感性,但乳腺X线摄影(mammography)检查仍然是乳腺癌早期发现、早期诊断的首选方法[1]。随着我国百万妇女乳腺X线筛查工作的进展,标准的检查手段是十分必要的。     

钼靶X线应用对早期乳腺癌筛查诊断价值的研究

目的探讨钼靶X线应用在早期乳腺癌筛查诊断中的价值。方法对280例患者进行钼靶X线早期乳腺癌筛查,回顾分析钼靶X线检查结果。结果 280例患者共检出乳腺肿瘤患者49例,检出率为17.5%,其中恶性肿瘤41例,良性肿瘤8例;最终诊断结果为恶性肿瘤43例,良性肿瘤10例,阳性符合率为92.4%,2例患者漏诊。结论钼靶X线用于早期乳腺癌诊断能够帮助患者尽早发现病变、及时治疗,在提高乳腺癌的治愈率和改善患者预后及生活质量,具有较高的诊断价值。     

对46例钼靶检出乳腺癌病例的回顾性分析

目的初步了解本区乳腺癌的发病特点。方法用乳腺钼靶X线头足位及内外斜位投照对临床触诊乳腺癌疑似病例进行筛查。结果41～50岁为乳腺癌的高发年龄；检出的乳腺癌病例多为自行检查发现乳房肿块来诊；病变多发生于外上象限。结论普及育龄妇女的乳腺疾病防治知识，加强育龄妇女的乳腺防癌普查工作对早期发现乳腺癌有重要意义。     

Mammography screening: a current controversy

Breast cancer is the most commonly occurring cancer in women in the United States and the second leading cause of cancer deaths. Over the past several decades, there has been a concerted effort to detect and diagnose breast cancer in women at early stages using mammography, and a simultaneous increase in lawsuits filed against physicians for a delay in the diagnosis of the disease. Even though mammography screening has become a standard of care for middle-aged and older women, recent questions have been raised about the efficacy of breast cancer screening. After carefully reviewing the literature on this subject, I conclude that routine screening mammography in women older than 50 is an effective means of identifying early breast cancers and significantly reduces mortality.     

Breast imaging update

Screening mammography has been shown to reduce the number of deaths due to breast cancer. Recent data have shown that there is low patient and physician participation in screening mammography in Jamaica. Breast imaging is concerned primarily with early detection of breast cancer. Despite technological advances, mammography continues to play a pivotal role. In this report, the authors will review the available imaging modalities and their role in screening patients for breast cancer as well as the evaluation of the symptomatic patient with particular reference to the situation in Jamaica.     

乳腺癌放疗导致心脏损伤的相关研究进展

放疗已被公认为可以提高乳腺癌患者的局部控制率以及总生存率。但是,由于乳腺癌患者的生存期得到了极大改善,关于乳腺癌放疗导致的心脏损伤得到了越来越多的关注,相关调查显示,心脏毒性已经是早期乳腺癌患者放疗后非乳腺癌死亡的主要原因之一。然而,对于放疗导致心脏损伤的机制及相关影响因素的认识并不全面,缺乏有针对性的治疗方法,这将成为日后研究的热点。     

磁共振成像与超声在乳腺癌诊断中的应用进展

乳腺癌是女性肿瘤中常见的恶性肿瘤,其发病率呈上升趋势,严重影响女性的健康及生活质量。目前对于乳腺癌的诊断临床上有很多方法,影像学诊断始终是临床上应用于乳腺癌诊断的常规手段,对于乳腺癌的筛查和临床诊断提供了重要的参考依据。磁共振成像(MRI)和超声在临床上已广泛应用于乳腺癌的早期诊断,MRI的多种成像方式、超声弹性成像及彩色多普勒超声的出现都极大地提高了对乳腺癌诊断的灵敏性和特异性。     

Age as a factor in breast cancer knowledge, attitudes and screening behaviour.

OBJECTIVE: To determine whether there are age-related differences in knowledge, attitudes and behaviour with respect to breast cancer and whether the differences reflect the age-specific Canadian recommendations on breast cancer screening. DESIGN: Telephone survey. SETTING: Two cities and five towns and their surrounding areas in Alberta. PARTICIPANTS: The age-specific, randomly selected sample comprised 1284 women aged 40 to 75 years who did not have breast cancer. Of the 1741 eligible women who were contacted, 1350 (78%) agreed to participate; 66 were excluded because of age ineligibility or a history of breast cancer. MAIN OUTCOME MEASURE: Frequency of knowledge, attitudes and behaviour with respect to breast cancer, by age group. RESULTS: Knowledge of breast cancer risk factors was generally low and decreased with age. Few women were aware of the Canadian recommendations on breast self-examination, physical examination of the breasts by a health care practitioner and mammographic screening. Older women believed they were less susceptible to breast cancer than younger women and were less likely to have positive attitudes toward screening. Self-examination was performed 9 to 15 times per year by 424 women (33%), and 810 (63%) had been examined by a health care professional in the past year. Although 664 (52%) had undergone mammography, the proportion decreased with age after age 59. The main barriers to mammography were lack of physician referral and the woman's belief that the procedure is unnecessary if she is healthy. CONCLUSIONS: Education is needed to increase breast cancer knowledge, promote the Canadian recommendations for early detection of breast cancer and decrease negative beliefs about the disease. Changes in the behaviour of women and physicians are needed to increase the use of breast self-examination, clinical breast examination by a health care professional and mammographic screening. Reaching women in the upper range (60 to 69 years) of the target group for mammographic screening should be a focus in promoting early detection of breast cancer.     

农村妇女宫颈癌和乳腺癌筛查的实践与探讨

目的通过对农村妇女宫颈癌和乳腺癌的筛查实践,探讨宫颈癌和乳腺癌联合筛查的模式及效果。方法 2009年—2011年襄垣县妇幼保健院对该县适龄农村妇女开展宫颈癌和乳腺癌筛查。结果此次筛查共完成27 517名妇女的宫颈癌筛查,6 122名妇女的乳腺癌筛查,其中宫颈上皮内瘤变Ⅱ级(CINⅡ)及以上病变的患病率为0.49%,早诊率为91.2%。乳腺良性肿瘤33例(0.53%);乳腺癌2例(0.03%),早诊率为50。%结论宫颈癌检查有筛查基础,筛查及早诊、早治效果明显。乳腺癌筛查仍需规范,须加强技术培训,提高筛查水平。筛查体系和技术队伍建设是基层妇女保健服务的保证,对农村妇女同时进行宫颈癌、乳腺癌联合筛查优于单一项目筛查。     

健康体检中高频超声对乳腺癌的早期诊断价值

目的探讨高频超声在乳腺防癌普查中的价值。方法使用8～13MHz高频探头对5610名健康体检的女性进行常规乳腺检查,可疑乳腺癌的病例施行超声引导自动活检。对检查阴性的1120名妇女进行2年随访。结果 12例可疑乳腺癌中,6例经穿刺活检诊断为乳腺癌;12例手术后,病理诊断为早期浸润型导管癌4例、浸润型导管癌1例、导管内乳头状癌2例、髓样癌1例、纤维腺瘤3例、导管内乳头状瘤1例。检出乳腺癌8例,占全部受检者的0.14％。结论使用高频超声对乳腺进行防癌普查,并对可疑病例在超声引导下活检,对乳腺癌的早期发现、早期诊断、早期治疗具有重要价值。     

抗HER2靶向药物治疗HER2阳性乳腺癌脑转移的研究进展

乳腺癌已成为全球发病率最高的恶性肿瘤,同时也是引起女性肿瘤相关死亡的重要原因之一。尽管早期乳腺癌可通过手术及辅助治疗得到治愈,然而仍有部分患者出现转移。一旦发生远处转移,患者5年生存率显著下降。相较于其他转移部位,乳腺癌脑转移(breast cancer brain metastasis,BCBM)患者生存时间最短,仅有3~6个月。由于血脑屏障(blood brain barrier,BBB)的存在,增加了BCBM的治疗难度,是缩短患者生存时间的重要原因之一。人表皮生长因子受体2(human epidermal growth factor receptor 2,HER2)阳性患者脑转移发生率较高,近年来各种抗HER2靶向治疗药物为HER2阳性脑转移患者带来了新的挑战和希望。如何延长HER2阳性脑转移患者的生存时间、提高患者生活质量已成为转移性乳腺癌(metastatic breast cancer,MBC)领域临床研究的热点问题。本文根据国内外的最新研究成果,对抗HER2靶向药物在HER2阳性脑转移患者中的应用进行综述,以促进对BCBM的认识,为HER2阳性BCBM患者的治疗及相关临床研究提供参考。     

If you think you've got a lump, they'll screen you. Informed consent, health promotion, and breast cancer

A great deal has been written about information that is or should be provided when seeking consent to medical research and treatment. Relatively little attention has been paid to information describing health promotion interventions. This paper critically examines some information material describing three different methods of encouraging early presentation of breast cancer in the UK: the NHS breast screening programme, breast self examination, and breast awareness. Findings from a content analysis of printed material and a series of focus group discussions that included women who speak little or no English were organised around the Department of Health's recommendations about the information which should be provided when seeking consent to treatment and research. They exposed inconsistencies, ambiguities, and gaps, which when taken together suggest both compliance and non-compliance are being achieved in the absence of informed consent. The findings also provide a starting point for a discussion about how informed consent to health promotion might be sought.     

超声声脉冲辐射力弹性成像量化技术联合超微血管成像检查对早期乳腺癌的筛查诊断价值研究

背景　乳腺癌是女性常见的恶性肿瘤,超声声脉冲辐射力弹性成像（ARFI）量化技术和超微血管成像（SMI）检查是早期乳腺癌的常用筛查诊断手段,但二者各具优缺点,超声ARFI量化技术联合SMI检查应用于早期乳腺癌诊断的研究较少。目的　探讨超声ARFI量化技术联合SMI检查对早期乳腺癌的筛查诊断价值。方法　收集2017年1月-2018年12月于安徽医科大学附属省立医院就诊的以乳腺肿块为主要临床表现的160例患者作为研究对象,均行ARFI和SMI检查,其中ARFI采用量化技术进行处理,ARFI和SMI检查之后行病理检查。分别比较ARFI检查、SMI检查、ARFI+SMI检查与病理检查结果的一致性、灵敏度和特异度。结果　160例患者经病理检查确诊为早期乳腺癌124例、良性病变36例;早期乳腺癌确诊率为72.3%。ARFI检查、SMI检查、ARFI+SMI检查与病理结果一致性程度分别为中、中、优（Kappa=0.569、0.529、0.880,P<0.05）。ARFI检查筛查诊断早期乳腺癌的灵敏度、特异度分别为79.8%和88.9%,SMI检查筛查诊断早期乳腺癌的灵敏度、特异度分别为78.2%和86.1%,ARFI+SMI检查筛查诊断早期乳腺癌的灵敏度、特异度分别为95.2%和97.2%。不同检查方法灵敏度比较,差异有统计学意义（P<0.05）;不同检查方法特异度比较,差异无统计学意义（P>0.05）;组间比较显示,ARFI+SMI检查的灵敏度高于ARFI、SMI检查（P<0.05）。结论　ARFI检查和SMI检查均是早期乳腺癌筛查诊断的重要检查方法,而两种检查方法联合应用能够提高早期乳腺癌筛查诊断的灵敏度,临床上可根据具体情况选择ARFI量化技术联合SMI检查对早期乳腺癌进行筛查诊断。