乳腺结核X线钼靶检查误诊分析

目的：提高乳腺结核诊断的准确性,减少误诊。方法：对1996-10～2007-01被病理证实为乳腺结核而X线钼靶检查误诊的10例病例做回顾性分析。结果：误诊为乳腺癌5例,乳腺炎及慢性乳腺炎3例,乳腺脓肿1例,浆细胞性乳腺炎1例。结论：X线钼靶检查对乳腺结核诊断缺少特异性,需结合临床及其它检查方法的综合应用。     

乳腺钼靶X线摄片对乳腺疾病的诊断价值

目的 探讨X线钼靶摄片对乳腺疾病的诊断价值.方法 通过200例乳腺疾病的X线钼靶摄片分析,临床观察与手术病理相结合,评价X线钼靶摄片对乳腺良恶性疾病的鉴别诊断价值.结果 X线钼靶对伴微小钙化的早期乳腺癌的诊断具有一定的特异性.结论 X线钼靶对乳腺癌的检出和早期诊断有重要价值.     

84例乳腺肿瘤乳腺钼靶X线误诊分析

目的：探讨乳腺钼靶X线诊断乳腺良、恶性肿瘤的价值.方法：回顾性分析经病理证实的84例乳腺肿瘤患者,术前均行乳腺钼靶摄影,钼靶X线诊断结果与病理结果对照比较.结果：误诊13例,其中恶性病变误诊为良性7例,分别为乳头状癌、浸润性导管癌、间叶源性肿瘤（低度恶性）、乳腺黏液癌,良性病变误诊为恶性4例,分别为乳腺纤维瘤及肉芽肿性病变,乳腺纤维瘤和乳腺炎性脓肿误诊为乳腺增生各1例.结论：钼靶X线乳腺肿块病变特征结合临床资料,对乳腺良恶性肿瘤的鉴别诊断具有较高的临床价值.     

妇女乳腺钼靶X线片135例分析

目的:分析135例妇女乳腺钼靶X线特征,探讨钼靶X线对乳腺疾病的诊断价值。方法:将经手术病理证实的135例乳腺疾病患者均行钼靶X线摄影检查,结合手术病理观察其影像学特征,分析钼靶X线在乳腺良恶性疾病的诊断价值。结果:钼靶X线诊断乳腺良恶性肿瘤在肿块形态、边缘毛刺及钙化等方面差异有统计学意义(P<0.05);术后经病理证实恶性病变12例,良性病变123例,经钼靶诊断恶性病变9例(符合率75%),良性病变123例(符合率100%),诊断符合率两者差异有统计学意义(P<0.05)。结论:钼靶X线摄影对乳腺良恶性疾病的鉴别,对乳腺癌的早期诊断有重要价值。     

全数字化钼铑双靶X线在乳腺疾病诊断中的价值

目的：分析在乳腺疾病中应用全数字化钼铑双靶X线的诊断价值。方法：对我院从2012年1月至2015年1月应用全数字化钼铑双靶X机进行检查的3256例乳腺患者的诊断结果进行分析,手术患者与病理结果进行对比。结果：全数字化钼铑双靶X线共检出乳腺疾病患者2813例,其中乳腺增生病2405例,乳腺纤维腺瘤213例,乳腺导管扩扩张86例,乳腺癌109例。其中有203例经过手术病理证实,诊断总符合率为95．6％。结论：目前,全数字化乳腺钼铑双靶X线是诊断乳腺癌的首选方法。     

钼靶X线对乳腺疾病的诊断价值

目的评价钼靶X线成像在检查乳腺疾病中的诊断价值。方法 52例均为女性,年龄25～65岁,平均45.6岁,均行乳腺钼靶X线摄影并经手术病理证实。结果术前乳腺钼靶X线诊断乳腺癌25例,手术病理证实乳腺癌24例和乳腺良性肿瘤1例;术前乳腺钼靶X线诊断良性肿瘤10例,手术病理报告纤维腺瘤8例、增生结节1例及乳腺癌1例;术前乳腺钼靶摄影诊断乳腺小叶增生15例及阴性2例,术后病理证实小叶增生15例、囊肿1例及增生结节1例。结论乳腺钼靶X线摄影是早期发现和早期诊断乳腺癌的首选检查方法,也可作为体检和普查使用。     

乳腺B超和钼靶检查在乳腺癌筛查中的价值分析

目的：探讨乳腺B超和钼靶检查在乳腺癌筛查中的诊断价值。方法回顾性分析我院妇科门诊2013年8月—2014年8月经乳腺癌筛查结合病理诊断确诊为乳腺癌的68例患者的临床资料,观察诊断准确率。结果在68例确诊的乳腺癌患者中,乳腺B超检查、X线钼靶检查的诊断结果与实际诊断符合率分别为70.59%,76.47%,乳腺B超联合X线钼靶检查的诊断准确率为94.12%。乳腺B超和X线钼靶检查诊断准确率差异较小（P﹥0.05）,乳腺B超联合X线钼靶检查的准确率最高。结论乳腺B超、X线钼靶检查是乳腺癌筛选的常用检查方法,各有优势和缺陷,联合使用可以提高诊断的准确率。     

男性乳腺发育症的X线表现

目的 探讨男性乳腺发育症的钼靶X线表现。方法 对12例男性乳腺肿块患者用意大利IMS公司生产的GITTO-TECH全智能高解析钼靶机摄片诊断。并与病理对照。结果 12例男性乳腺肿块病理证实为乳腺发育症。钼靶X线确诊者10例，另2例误诊为男性乳腺癌。结论 男性乳腺发育症根据典型钼靶X线表现可确诊。必要时行针刺活检，需与男性乳腺癌加以鉴别。     

钼靶X线片摄影在乳腺癌诊断中的作用

目的:评价钼靶X线片摄影在乳腺癌诊断中的价值。方法:对16例乳腺癌患者钼靶X线片进行回顾性分析。结果:钼靶X线片诊断与病理结果对照,除1例误诊为纤维腺瘤,1例乳头溢液患者平片表现为假阴性外,其余14例X线片诊断结果均与病理相符。结论:钼靶乳腺X线片摄影是诊断乳腺癌的重要影像方法之一。     

男性乳腺发育症的X线表现

目的探讨男性乳腺发育症的钼靶X线表现。方法对12例男性乳腺肿块患者用意大利IMS公司生产的GITTO-TECH全智能高解析钼靶机摄片诊断,并与病理对照。结果12例男性乳腺肿块病理证实为乳腺发育症,钼靶X线确诊者10例,另2例误诊为男性乳腺癌。结论男性乳腺发育症根据典型钼靶X线表现可确诊,必要时行针刺活检,需与男性乳腺癌加以鉴别。     

The diagnosis of breast cancer: a clinical and mammographic comparison

The early and accurate diagnosis of breast cancer is of paramount importance in the symptomatic patient. In this study, the sensitivity and false negative rates of clinical assessment and community mammographic imaging are measured and compared. One hundred and sixty-nine histologically proven breast cancers, derived from one surgeon's practice, were clinically assessed. Of these, 108 were additionally assessed by mammography. Eighty-seven per cent of the patients with breast cancer presented with a lump. In 82.8% of cases the patient or her partner found the lump, while 12.3% of lumps were found by the family practitioner. The false negative rate for clinical diagnosis was 19%, and for mammographic diagnosis it was 29%. Premenopausal mammographic diagnosis had a significantly higher false negative rate (54%) than postmenopausal diagnosis (14%). Mammographic examination had a particularly high false negative rate (65%) when cancer was thought clinically to be of "low index of suspicion". The clinical evaluation of and the indications for biopsy of the symptomatic breast remain the essential step in the diagnosis of breast cancer.     

超声联合钼靶诊断乳腺浸润性导管癌及超声征象与P53表达的相关性

目的 研究高频彩色多普勒超声与钼靶X线联合诊断乳腺浸润性导管癌的价值,并探讨超声征象与P53基因表达的相关性.方法 选取79例均经术后病理证实为乳腺浸润性导管癌,分析彩色多普勒声像图特征和钼靶X线结果,比较两者诊断乳腺浸润性导管癌的准确率,并将这些病理标本经免疫组织化学染色检测P53基因表达情况,并研究其与超声征象之间的相关性.结果 79例乳腺癌的患者中,超声诊断准确率为89.87% （71/79）,钼靶X线诊断的准确率为73.42%（58/79）,两者联合诊断的准确率为92.41%（73/79）.超声征象中肿块后方伴有回声衰减者和肿块内血流信号较丰富者（血流信号Ⅱ~Ⅲ级）P53基因阳性发生率高,差异有统计学意义（P〈0.05）.伴有腋窝淋巴结肿大者P53基因阳性者较未发生淋巴结转移者高,两者差异有统计学意义（P〈0.05）.结论 钼靶X线联合高频彩色多普勒超声可以提高乳腺浸润性导管癌的准确率,高频超声彩色多普勒表现征象与P53基因表达具有相关性,且对于预测肿瘤的良恶性及临床预后具有一定的指导意义.     

不同病理类型伴钙化乳腺癌X线征象

目的研究比较不同病理类型伴钙化乳腺癌的X线征象,提高对乳腺癌的诊断水平。方法搜集术前行数字化钼靶X线检查术后经病理证实的伴钙化乳腺癌患者82例,将不同病理类型乳腺癌的X线征象进行对照。结果伴钙化乳腺癌中,单纯钙化多见于导管原位癌和浸润性导管癌,钙化伴肿块在各种病理类型乳腺癌中均可见,以浸润性导管癌为多,钙化伴结构紊乱者多见于浸润性导管癌。结论乳腺钼靶X线检查可作出乳腺癌组织类型的初步诊断。     

The misuse of mammography in the management of breast cancer revisited

A second study of the use of mammography as a diagnostic procedure in women with breast symptoms is reported. In a two-year period during which 468 patients with a new diagnosis of breast cancer were seen, 238 women had undergone mammography before referral to the Department of Radiation Oncology, Westmead Hospital. For 73 (30.7%) patients the mammographic report was falsely negative. Among those 73 patients with a falsely negative mammographic report, 40 women experienced a mean treatment delay of 12.7 months (range, three to 60 months). A negative mammographic result was significantly (P less than 0.001) more likely to be obtained in younger women. When the women with an initially negative mammographic result represented, they did so with disease of a more advanced stage. This, we contend, is related to the delay in their definitive treatment as caused by the first falsely negative mammographic report. Theoretical calculations are presented; under varying conditions of sensitivity and specificity, these show that, even with the addition of specialist opinion, significant proportions of patients with breast cancer will have a mammographic result which is falsely reassuring. The identification of these subsets depends on histological or cytological examination of the tumour. This is a decision that best is made, in our opinion, by a specialist in breast-cancer management.     

The effect of mammographic screening on invasive breast cancer in Western Australia

OBJECTIVE: To determine whether mammographic screening has affected the presentation of invasive breast cancer in Western Australia. DESIGN: Population-based reviews of the presentation of all invasive breast cancers diagnosed in Western Australia in 1989 and 1994. SETTING: Western Australia (population 1.8 million). Active recruitment of women aged 50-69 years for mammographic screening began in 1989. MAIN OUTCOME MEASURES: Size and stage of invasive breast cancers at diagnosis. RESULTS: From 1989 to 1994, the age-standardised incidence rose from 109 to 123 per 100,000 woman-years, based on 584 and 750 cases, respectively. The proportion of all invasive breast cancers detected as a result of a mammogram increased from 9.2% in 1989 to 34.5% in 1994. Among the cases where relevant information was recorded, the proportion of "impalpable" tumours increased from 7.7% in 1989 to 27.6% in 1994, and the average size of palpable tumours fell. There was an unexpected increase in the proportion of tumors that were negative on assays for oestrogen and progesterone receptors. CONCLUSIONS: A relatively simple and inexpensive clinical review has boosted confidence that the outlay of public monies required to establish and conduct screening in Australia appears likely to yield the reductions in mortality from breast cancer that would be predicted on the basis of the earlier controlled trials of mammography.     

钼靶摄片诊断乳腺导管内癌价值的初步探讨

目的探讨乳腺钼靶摄片对乳腺导管内癌（ductal carcinoma in Situ,DCIS）的诊断价值。方法按照病人主诉分组,回顾性分析20例患者、21个经病理证实为DCIS病灶的钼靶影像特征,与病理结果对照研究。结栗以触诊乳腺肿物为主诉的9例患者10个病灶中,表现为结节并微小钙化者6例,乳头血性溢液者1例,片状增高密度影2例,另1例患者影像表现阴性,上述后3例病灶行细针穿刺细胞学检查确诊;以腺体增厚为主诉的5例患者中,钼靶表现为腺体结构紊乱,密度不均,其中2例伴微小钙化及乳头溢液,单纯性微小钙化3例;以单纯性乳头溢液为主诉者2例,均伴微小钙化,导管造影示导管局部显影中断或间断显影;以乳腺癌术后复查发现另一侧乳腺单纯性微小钙化灶者2例;1位患者因乳腺脂肪瘤而漏诊。结论钼靶影像学能为DCIS的诊断提供重要依据,尤其对临床检查阴性的患者,乳腺钼靶摄片辅以导管造影及细针穿刺细胞学检查是诊断早期乳腺癌不可或缺的手段。     

CT灌注和钼靶摄影在乳腺疾病诊断中的比较研究

目的探讨CT灌注和X线摄影对乳腺疾病的诊断价值。材料和方法53例乳腺病变均行X线摄影和CT灌注检查,与病理结果对照。结果 X线摄影、CT灌注诊断正确率分别为77.36%和88.68%,综合X线摄影和CT定性诊断正确率为94.34%,三者差异有显著性意义(P0.05)。CT灌注中,乳腺良、恶性病变的BF、BV、PS的均值均有显著性差异(P0.05)。CT灌注在对病变范围、乳腺癌坏死灶的判别方面优于X线摄影(P0.05)。X线摄影对钙化灶的定性优于CT灌注(P0.05)。结论 X线摄影和CT灌注具有互补性,两者结合可提高乳腺癌诊断率。     

Current imaging modalities for the diagnosis of breast cancer

Although mammography still remains the gold standard for breast cancer screening and diagnosis, it typically cannot differentiate benign from malignant disease and is less accurate in patients with dense glandular breasts. This article is an overview of imaging modalities that have emerged to augment mammography and improve the accuracy of non-invasive breast cancer diagnosis. Ultrasound is currently used to differentiate breast masses and guide aspirations and biopsies. Magnetic resonance imaging has excellent sensitivity in demonstrating breast cancer but a low specificity. Nuclear medicine studies have recently emerged that detect the increased metabolic rate and vascularity of breast cancers. Other modalities, such as thermography and computed tomography, have a more limited utility for breast cancer diagnosis. Digital mammography is among other emerging technological advancements that will continue to develop and improve the accuracy of breast cancer diagnosis in the future.     

Mammography: a surgeon''s experience.

Most reports advocating mammography have been written by radiologists rather than by clinicians who are frequently confronted by women with breast complaints. The value of mammography in managing patients with breast problems was studied by reviewing its role in 1026 breast consultations; there were 129 patients with cancer. Mammography was performed in 95 patients. The procedure hastened the diagnosis of one comedocarcinoma, and in another patient was suspicious 3 years before she presented with a locally advanced lesion. It missed six cancers. In seven patients it recognized clinically obvious cancers, though in one of these it had given negative results 10 months before the patient presented with a lesion 15 cm in diameter. It also falsely suggested the possibility of cancer in 28 women. In the other 52 patients the clinical diagnosis of a benign condition was usually fairly evident. The morbidity caused by mammography does not seem to have been widely appreciated, no doubt because of the hope that clinically unrecognized cancers would be found by it. Most breast problems can be diagnosed without mammography.     

双侧原发性乳腺癌的X线评价与临床对照研究

目的:早期发现对侧乳腺癌。方法:搜集36例双侧原发性乳腺癌患者的临床、病理及X线资料进行对照分析。结果:(1)20例同时性乳腺癌中19例X线明确诊断双侧原发性乳腺癌。另1例一侧诊断乳腺癌,另一侧误诊为腺体增生。临床诊断双侧原发性乳腺癌8例,另12例未发现乳腺癌。(2)16例异时性乳腺癌中,后发癌中临床11例触及肿物,摄片诊断为乳腺癌;另5例临床未触及肿物,摄片发现乳腺癌。结论:(1)乳腺摄影有助于早期发现对侧原发乳腺癌。(2)临床触不到肿块就不会有癌存在的观念应该改变。(3)双侧乳腺应同时进行X线检查,有利于早期发现病灶。同时为以后对照比较提供资料。