乳腺X线摄影中微钙化对乳腺导管内原位癌的诊断价值

目的 探讨乳腺X线摄影中微钙化对乳腺导管内原位癌(DCIS)的诊断价值.方法 回顾性分析住院治疗的163例乳腺肿物患者的临床资料,研究其乳腺X线摄影和病理检查结果,分析乳腺X线摄影诊断良、恶性肿瘤与病理诊断结果的一致性和乳腺X线摄影发现微钙化与病理诊断DCIS的一致性.结果 乳腺X线摄影诊断良性肿瘤44例,恶性肿瘤119例.病理检查结果诊断为良性肿瘤37例,恶性肿瘤126例.乳腺X线摄影诊断良、恶性肿瘤与病理诊断结果的一致性为中等(Kappa=0.492,t=6.323,P﹤0.01),诊断乳腺癌的敏感度为84.92％(107/126),特异度为67.57％(25/37),阳性预测值为89.92％(107/119),阴性预测值为56.82％(25/44).乳腺X线摄影发现微钙化与病理诊断DCIS的一致性较差(Kappa=0.181,t=3.125,P﹤0.01).乳腺X线摄影发现微钙化对DCIS诊断的敏感度为77.78％(21/27),特异度为55.15％(75/136),阳性预测值为25.61％(21/82),阴性预测值为92.59％(75/81).结论 乳腺X线摄影能够作为临床筛查乳腺癌的有效手段,但是单纯寻找微钙化以诊断DCIS效能较低,不能作为诊断DCIS的标准.     

X线摄影、三维断层摄影和磁共振对乳腺导管原位癌的诊断价值比较

目的评估全数字化乳腺X线摄影(FFDM)、三维断层摄影(DBT)和磁共振成像(MRI)对乳腺导管原位癌(DCIS)的诊断价值。方法选取2017年1月至2018年12月江苏省肿瘤医院行乳腺手术的DCIS患者42例,共43个病灶,术前均行FFDM、DBT和MRI检查,分析其影像学特征,比较这三种方法诊断DCIS的敏感度、特异度和准确度。结果 MRI对DCIS的诊断敏感度为90.7%(39/43),主要表现为非肿块样强化;FFDM和DBT对DCIS的敏感度分别是81.4%(34/43)和60.5%(26/43),主要表现为钙化,伴或不伴肿块。MRI、DBT、FFDM诊断DCIS的特异度分别为92.0%、85.4%、77.4%;准确度分别为91.8%、84.7%、75.5%。MRI诊断DCIS的敏感度较FFDM更高(χ~2=10.65,P0.05),MRI和DBT的诊断准确度均较FFDM更高(χ~2=7.18、9.28,P0.05)。结论 MRI、DBT和FFDM均能诊断DCIS,但MRI能更好地诊断DCIS。     

胸部CT和MRI对胸段食管癌淋巴结转移患者的诊断价值

目的探讨胸部电子计算机断层扫描(CT)与磁共振(MRI)对胸段食管癌淋巴结转移患者的临床诊断价值。方法选取2016年3月至2018年5月间铜川市人民医院收治的122例食管癌患者,均行胸部CT与MRI检查,以病理诊断为金标准,判断两种方法及两种方法联合的诊断价值。结果 CT诊断结果中阳性88例,阴性34例,MRI诊断结果中阳性82例,阴性40例,两者联合诊断阳性95例,阴性27例。病理检查显示,98例患者被确诊为食管癌淋巴结转移。CT误诊11例,漏诊21例; MRI误诊8例,漏诊24例;两者联合检查,误诊3例,漏诊6例。CT诊断敏感度78. 6%,特异度51. 2%,诊断准确率73. 8%; MRI诊断敏感度75. 5%,特异度40. 0%,诊断准确率73. 8%,两者联合诊断敏感度93. 9%,特异度87. 0%,诊断准确率92. 6%。结论胸部CT与MRI两者联合诊断食管癌患者淋巴结转移有更高的敏感度、特异度和诊断准确率,值得临床推广。     

448例乳腺肿块细针吸取细胞学诊断分析

目的:探讨细针吸取细胞学(fine needle aspiration cytology FNAC)对乳腺肿块的诊断价值,提高其诊断准确率.方法:回顾性分析湖北省荆州市肿瘤医院病理科细胞室2004年9月-2007年9月间448例有术后组织病理学诊断证实的乳腺肿块FNAC资料.结果:FNAC诊断敏感度96.1%,特异度96.9%,假阴性率3.9%,假阳性率3.1%,总准确率96.7%,穿刺取材成功率99.33%, 乳腺癌明确诊断率 75.97%;急性乳腺炎、乳腺囊肿、乳汁潴留囊肿、男性乳腺发育和大部分乳腺纤维腺瘤特异度100%且能确定组织学类型.结论:FNAC对乳腺肿块良恶性质的诊断准确率很高,对一些乳腺癌诊断准确,可以部分替代乳腺癌术中冰冻切片,对部分良性肿块可以确定组织学类型.     

乳腺癌磁共振成像误诊和漏诊病例的临床、影像和病理学特点

目的 探讨乳腺癌磁共振成像（MRI）漏诊和误诊病例的临床、影像和病理学改变可能的原因.方法 回顾总结术前行乳腺MRI、超声和X线检查患者121例临床资料,经穿刺或手术病理证实为乳腺良、恶性病变共241个,采用BL-RADS分类,分析其影像学表现,并进行最终评估.由外科、影像科和病理科医生共同分析MRI误诊和漏诊病例的可能原因、病理学基础.结果 241个乳腺病变中恶性120个、良性121个.MRI漏诊4个,分别为导管内乳头状瘤病2个、纤维腺瘤2个,均为良性.MRI误诊23个,其中高估16个,高估的病变包括慢性乳腺炎3个、硬化性腺病各3个,纤维腺瘤、结节腺病伴重度非典型增生、导管内乳头状瘤、乳腺腺病各2个,乳腺癌胸肌侵犯、乳腺癌腋窝淋巴结转移各1个;低估7个,包括浸润性导管癌2个、黏液癌1个、乳腺原位癌2个、盲管腺病伴重度非典型增生局灶恶变1个、炎性乳腺癌化疗后1个. MRI诊断乳腺癌的敏感度为95.83％（115/120）,特异度为72.73％（88/121）,诊断准确率为84.23％（203/241）.乳腺MRI发现病变与乳腺超声或X线形态或临床检查的符合率为75.10％（181/241）.结论 MRI误诊和漏诊常发生于乳腺病灶较小、形态学和血流动力学恶性表现不典型者,特别是导管内病变.应结合体检、乳腺X线和超声检查以提高诊断准确度、减少漏诊.     

增强磁共振成像对乳腺微钙化灶的管理价值

目的评估乳腺增强MRI对乳腺X线检查为BI-RADS 4类微钙化灶的管理价值。 方法回顾性分析2017年2月至2019年6月在四川省妇幼保健院行乳腺X线检查引导下金属导丝定位活组织检查的87例BI-RADS 4类乳腺微钙化灶患者资料,评价此部分患者在术前接受增强MRI检查的临床意义。增强MRI与病理诊断对乳腺癌检出率的差异比较采用McNemar检验,增强MRI与乳腺X线检查对乳腺癌检出敏感度的差异比较采用Fisher确切概率法,增强MRI与乳腺X线检查对乳腺癌检出特异度、阳性预测值、阴性预测值的差异比较采用χ²检验。 结果87例患者中病理组织学检查结果为良性者71例,DCIS 6例,浸润性导管癌(IDC)10例。BI-RADS为4A、4B和4C的患者,病理组织学检查为恶性的比例分别为2.4%(1/42),24.3%(9/37)和6/8。乳腺增强MRI对乳腺X线检查为BI-RADS 4类的微钙化灶判断的敏感度、特异度、阳性预测值、阴性预测值和诊断正确率分别为14/16、74.7%(53/71)、43.8%(14/32)、96.4%(53/55)和77.0%(67/87)。增强MRI的诊断特异度高于乳腺X线检查[74.7%(53/71)比57.8%(41/71),χ²＝4.532,P＝0.033],74.7%(53/71)的良性病灶可通过增强MRI检查避免活组织检查,但有2/16的恶性病灶被增强MRI误判为阴性。 结论乳腺增强MRI有助于降低乳腺X线检查为BI-RADS 4类微钙化灶的活组织检查比例,可有效避免乳腺恶性肿瘤的漏诊,有利于临床医师根据患者具体情况对BI-RADS 4类微钙化灶进行合理的诊疗。     

乳腺X线摄影联合超声与MRI对乳腺癌诊断价值的对比研究

目的探讨乳腺X线摄影联合超声与MRI对乳腺癌的诊断价值。 方法回顾性分析2015年4月至2016年12月在河北医科大学第四医院就诊的255例(260个病灶)乳腺疾病患者的X线摄影、超声及MRI诊断资料。以病理诊断为金标准,X线摄影、超声与MRI诊断结果依据BI-RADS分类,4～5类为阳性结果,采用受试者工作特征(ROC)曲线评价两者的诊断效能。采用Kappa检验评价两者诊断乳腺癌与病理诊断的一致性。 结果乳腺X线摄影联合超声诊断乳腺癌的敏感度为98.6%(204/207),特异度为77.4%(41/53),准确率为94.2%(245/260),与病理诊断的一致性非常好(Kappa＝0.810,P<0.001); MRI诊断乳腺癌的敏感度为98.1% (203/207),特异度为66.0%(35/53),准确率为91.5%(238/260),与病理诊断的一致性好(Kappa＝0.711,P<0.001)。乳腺X线摄影联合超声和MRI诊断乳腺癌的ROC曲线下面积分别为0.902(95%CI：0.843～0.961,P<0.001)和0.893(95% CI：0.842～0.945,P<0.001),两者间差异无统计学意义(Z＝0.050,P >0.050)。 结论乳腺X线摄影联合超声与MRI相比,两者诊断价值相当,对乳腺癌的诊断准确率均较高。乳腺X线摄影联合超声由于简便和经济,可作为乳腺癌的首选检查方法,而MRI在乳腺癌术前评估中的作用不可替代。     

95例乳腺肿块X线检查与超声检查对比分析

目的　分析乳腺X线摄片检查与超声检查诊断乳腺肿块的价值。方法　对 95例乳腺肿块均进行乳腺X线摄片检查和超声检查 ,其中乳腺癌 5 4例 ,良性肿块 41例 ,并与术后病理相对照。结果　乳腺良性肿块超声检查的准确率明显高于X线检查(P <0 .0 5 )。结论　对乳腺良性肿块的诊断超声检查优于X线摄片检查。     

未扪及肿块的乳腺癌病灶定位与手术方法

目的 探讨仅影像学表现为恶性钙化而乳房未扪及肿块乳腺癌的病灶定位方法、手术方法及其治疗效果.方法 对61例乳房体检不能触及肿块、影像学检查也未发现肿块,仅X线钼靶片或超声检查显示恶性钙化病灶或局部血流丰富的乳腺癌(T1～2NOM0)患者,术前应用全数字化平板乳腺机(FFDM),对钙化病灶进行坐标法立体定位、术中精确切除病灶、术后应用FFDM法复检标本,同时行广基带血管腺体组织瓣Ⅰ期乳房内成形保乳手术(单发病灶者)或乳腺癌改良根治术(多中心病灶者).结果 50例行保乳手术的患者,坐标法定位病灶的准确率为100%(50/50).对病灶切缘阴性、FFDM复检无病灶残留者,其广基带血管腺体组织瓣乳腺Ⅰ期成形结果按JCRT标准,达优率为86.0%(43/50);Compliance差值为1.5 cm.11例行乳腺癌改良根治术,均为外弥漫性恶性钙化多中心病灶者.61例患者的随访时间为6～58个月(中位随访时间为39个月).全组仅1例远处转移,无局部复发患者.结论 对不能扪及肿块的乳腺癌病灶,应用FFDM坐标法定位,准确可行.对单发病灶者,在定位下行保乳手术,同时行广基带血管腺体组织瓣Ⅰ期乳房内成形术,疗效满意.     

两种常用乳腺检查方法对乳腺肿块诊断的价值

目的:应用X线钼靶摄片和近红外线扫描与病理对照,评价两种检查方法对乳腺肿块良恶性诊断的真实性。方法:80 例乳腺肿块患者术前均行两项检查并按病理结果分为恶性与良性疾病组,计算各方法的敏感性、准确率、阳性及阴性预期值。结果:经病理证实乳腺癌52 例,良性疾病28 例;乳腺X 线钼靶摄片敏感性为84 .6% (44/52) 、准确率75 % (60/80) 、阳性及阴性预期值为88%(44/50) 及80 % (16/20) ;近红外线扫描的上述各值依次为88 .5 % (46/52) 、78.8 % (63/80) 、85.2%(46/54) 、77 .3% (17/22) ;两项检查联合运用准确率为:90.0 % (72/80) 。结论:X 线钼靶摄片和近红外线扫描两项检查联合运用,可减少乳腺肿块疾病的误诊和漏诊     

全数字化乳腺X线摄影诊断中青年乳腺癌的价值

目的探讨全数字化乳腺X线摄影（FFDM）诊断中青年乳腺癌的应用价值。方法收集2008年9月至2011年6月进行FFDM检查并经病理证实的中青年乳腺癌与良性乳腺病患者共375例。X线诊断标准采用美国放射学会推荐的乳腺报告和数据系统（BI-RADS）：Ⅰ-Ⅲ级为良性,Ⅳ、Ⅴ级为恶性,并与病理结果对照;同时分析乳腺癌的X线表现。以致密型和多量腺体型为A组,少量腺体型和脂肪型为B组,两组灵敏度和特异度的比较采用χ^2检验。结果乳腺癌的X线征象包括肿块或结节、钙化、片状致密影、结构紊乱等。FFDM诊断的灵敏度为82．0％（91／111）,特异度为87．1％（230／264）,阳性预测值为72．8％（91／125）,阴性预测值为92．0％（230／250）,正确率为85．6％（321／375）。A、B两组的FFDM诊断灵敏度、特异度分别为74．5％（35／47）和87．5％（56／64）,84．4％（108／128）和89．7％（122／136）,其差异无统计学意义（P〉0．05）。结论全数字化乳腺X线摄影能及时发现乳腺病灶,对中青年乳腺癌具有较高的应用价值,X线诊断为BI—RADS—Ⅳ、Ⅴ级时建议行手术活组织检查。     

全视野数字化乳腺摄像与细针穿刺细胞学检查对乳腺肿块的诊断意义

目的评估细针穿刺活检与数字化乳腺摄像在乳腺肿块定性诊断中的准确性。方法102例乳腺肿块患者(年龄17～76岁,中位年龄50岁)均进行细针穿刺活检与数字化乳腺摄像检查,且所有患者均入院手术获得病理诊断,所得结果与最终的病理学诊断结果进行对照分析。结果102例患者中,最终病理确诊为乳腺癌者43例(42.2%),细针穿刺活检对乳腺癌检测的敏感性为90.7%(39/43),特异性为89.8%(53/59),总准确率为90.2%(92/102)。数字化乳腺摄像检查对乳腺癌的敏感性也是88.4%(38/43),而特异性是83.1%(49/59),总的准确率是85.3%(87/102)。细针穿刺活检假阴性的乳腺癌可通过数字化乳腺摄像检查得到正确诊断。结论细针穿刺活检与数字化乳腺摄像都是诊断乳腺疾病的准确有效方法,两者联合应用能够降低乳腺肿块的误诊率。     

Selective digital enhancement of conventional film mammography

Screening mammography continues to play a key role in the early diagnosis of non-palpable breast cancer. Approximately 5% of patients will have lesions on their mammograms that appear neither clearly benign nor malignant. The proper management of these patients is not well defined. In this study, the mammograms of 64 women who underwent breast biopsy were reviewed. After the initial review, the mammograms were reevaluated using a personal computer driven digital conversion and enhancement system. The majority of indeterminate lesions were assigned a determinate diagnosis by enhancing the areas of abnormality through enlargement, contrast adjustment, and brightness adjustment. The radiologists were able to maintain baseline sensitivity and specificity throughout this process. In contrast, enhancement of lesions initially assigned a diagnosis of characteristically benign or malignant demonstrated no advantage over plain film mammography. These findings suggest a role for the selective use of digital mammography and enhancement techniques. © Wiley-Liss, Inc.     

DBT联合FFDM在乳腺癌诊断中的价值研究

目的:探讨数字乳腺三维断层摄影技术（DBT）联合全数字化乳腺摄影(FFDM)在乳腺癌诊断中的价值。方法:前瞻性选取2015年10月至2017年10月哈励逊国际和平医院怀疑女性乳腺疾病的患者398例,均给予FFDM、DBT检查,根据乳腺影像报告和数据系统的分型标准(BI-RADS)对乳腺病灶进行分类,以病理结果为对照,分析FFDM、FFDM联合DBT对乳腺癌的诊断价值。结果:FFDM联合DBT检查的2类检出率明显高于FFDM检查（P＜0.05）;在诊断乳腺正常与良性病变中,FFDM联合DBT检查的2类检出率明显高于FFDM检查（P＜0.05）;在诊断乳腺癌中,FFDM联合DBT检查的5类检出率明显高于FFDM检查（P＜0.05）;FFDM联合DBT检查诊断乳腺癌的敏感度、准确度明显高于FFDM检查（P＜0.05）。结论:与单独FFDM检查比较,FFDM联合DBT可更有效地对乳腺病灶进行BI-RADS分类,有利于提高对乳腺癌诊断的敏感性、准确性,值得临床进一步推广。     

Combined use of fine needle aspiration cytology and full field digital mammography in preoperative assessment of breast masses

Objective: To evaluate the accuracy of these two methods and focus on the analysis and management of the false-negative cases.Methods: Results of full field digital mammography (FFDM) and fine needle aspiration cytology (FNAC)were obtained and analyzed from a consecutive of 102 women with palpable breast masses, results were correlated with the histopathological findings.Results: Of the 102 cases, malignancy was confirmed in 43 cases (42.16%) by final pathological examination, the sensitivity and specificity of cancer detection with FNA cytology was 90.7% (39/43) and 89.8% (53/59), respectively, the whole accuracy was 90.2% (92/102), with a positive predictive value of 86.7% (39/45) and a negative predictive value of 93.0% (53/57).FFDM gave a sensitivity of 88.4% (38/43), specificity of 83.1% (49/59), and whole accuracy 85.3% (87/102), the positive predictive value and negative predictive value was 79.2% (38/48) and 90.7% (49/54), respectively.All the FNAC-negative cancer cases were suggestive of malignancy by FFDM findings, however, the benign cases which presentas equivocal finding by FNA cytology, could not be ruled out the presence of malignancy.Conclusion: FNAC and FFDM both are accurate, effective and economical diagnostic modalities, combined use of these two methods can reduced the misdiagnosis rate of breast masses.     

Lower sensitivity of screening mammography after previous benign breast surgery

Few data are available on the effect of previous benign breast surgery on screening mammography accuracy. We determined whether sensitivity of screening mammography and tumor characteristics are different for women with and without previous benign breast surgery. We included a consecutive series of 317,398 screening mammograms of women screened between 1997 and 2008. During 2-year follow-up, clinical data, breast imaging, biopsy and surgery reports were collected from women with screen-detected or interval breast cancers. Screening sensitivity, tumor biology and tumor stages were compared between 168 women with breast cancer and prior ipsilateral benign breast surgery and 2,039 women with breast cancer but without previous ipsilateral, benign breast surgery. The sensitivity of screening mammography was significantly lower for women with prior surgery [64.3% (108/168) versus 73.4% (1,496/2,039), p = 0.01]. The concomitant increased interval cancer risk remained significant after logistic regression adjustment for age and breast density (OR = 1.5, 95% CI: 1.1-2.1). Comparing screen-detected cancers in women with and without prior breast surgery, no significant differences in estrogen receptor status (p = 0.56), mitotic activity (p = 0.17), proportions of large (T2+) tumors (p = 0.6) or lymph node positive tumors (p = 0.4) were found. Also for interval cancers, no differences were found in estrogen receptor status (p = 0.41), mitotic activity (p = 0.39), proportions of large tumors (p = 0.9) and lymph node positive tumors (p = 0.5) between women with and without prior breast surgery. We conclude that sensitivity of screening mammography is significantly lower in women with previous benign breast surgery than without, but tumor characteristics are comparable both for screen detected cancers and interval cancers.     

双模式数字乳腺体层合成成像对乳腺疾病的诊断价值

背景与目的：全数字化乳腺X线摄影（full-field digital mammography,FFDM）可显著降低乳腺癌的死亡率,但作为一种二维成像方式,对于致密型乳腺构成分类患者,其诊断灵敏度和特异度明显较低。探讨数字乳腺体层合成成像（digital breast tomosynthesis,DBT）结合FFDM对乳腺病变的鉴别诊断价值以及高分辨率扫描（high-resolution,HR）模式（扫描角度为40°,DBT-HR）和标准扫描（standard,ST）模式（扫描角度为15°,DBT-ST）诊断乳腺病变的价值。方法：前瞻性收集2016年7月—9月经临床或超声检查怀疑有乳腺异常病变,且经穿刺活检或术后病理学检查证实的175例女性乳腺疾病患者,行FFDM和DBT检查,随机进入DBT-HR组和DBT-ST组,对FFDM图像和DBT结合FFDM图像进行分析。参照2013版《乳腺影像报告和数据系统》（Breast Imaging Reporting and Data System,BI-RADS）分类标准,以病理学检查结果为金标准,采用受试者工作特征（receiver operating characteristic,ROC）曲线分析FFDM和DBT结合FFDM的诊断效能,根据不同的乳腺构成分类分别分析DBT-HR和DBT-ST的灵敏度和特异度。结果：175例患者共检出181个病灶,良性病灶50个,恶性病灶131个,所有入组病例的FFDM和FFDM结合DBT的灵敏度为81.92%和91.15%,特异度为77.45%和87.25%,两种方法的ROC曲线的曲线下面积（area under curve,AUC）差异有统计学意义（0.88 vs 0.94,Z值=5.37,P<0.01）。随机分入DBT-HR组病灶86个而DBT-ST组病灶95个。DBT-HR组FFDM和DBT主要征象表现一致率为83.14%,仅DBT可见率为3.49%,DBT-ST组FFDM和DBT主要征象表现一致率为92.63%,仅DBT可见率为0.53%。致密型乳房在结合DBT后灵敏度和特异度提高均较非致密型乳房明显,尤其是HR组致密型乳房灵敏度（18.72%）和ST组的致密型乳房的特异度（14.28%）均有所提高。结论：FFDM结合DBT的诊断效能优于FFDM,且DBT-HR优于DBT-ST,尤其是对致密型乳房的诊断。     

深度学习在联合超声和钼靶检查乳腺癌中的应用

目的:探讨深度学习在乳腺良恶性病变鉴别中的意义。方法:对100例乳腺疾病患者的X线钼靶及超声检查的数据用反向传播神经网络进行深度学习分析,随机选择50例样本作为训练样本,组成训练集,其余样本组成测试集。建立神经网络诊断模型,分析神经网络模型的诊断结果。结果:100例患者中,手术与病理证实乳腺恶性病变62例,乳腺良性肿瘤或肿瘤样病变38例,钼靶X线诊断的特异度、敏感度及诊断正确率分别为89.5%、87.1%和88.0%;B超诊断的特异度、敏感度及诊断正确率分别为86.8%、83.9%和85.0%。X线钼靶和B超无明显差异。而深度学习的神经网络的特异度为95.5％,敏感度为96.4％,总的正确率为96.0％,明显高于X线钼靶和B超,差异有高度统计学意义。结论:结合X线钼靶和B超检查的深度学习在判断乳腺良恶性病变性质方面有一定的应用价值。     

False-positive and false-negative cases of fine-needle aspiration cytology for palpable breast lesions.

BACKGROUND: Fine-needle aspiration cytology (FNA) is less traumatic and technically easy to apply to small breast tumors. METHODS: A total of 382 cases of palpable breast lesions that had undergone fine needle aspiration and histopathologic diagnosis were reviewed with an emphasis on the rate of false positive diagnoses in benign breast lesions. RESULTS: A diagnosis of " malignant " was made in 98 of the 382 specimens (25.6%). The predictive value for malignancy was 97.9%. The sensitivity, specificity, and accuracy of FNA were 86.3%, 98.2%, and 93.2%, respectively, when the " suspicious " group was considered positive for malignancy. The histologic subtypes of the 4 false-positive cases were epithelial proliferative lesions, ductal or lobular hyperplasia. None of these 4 cases were definitely diagnosed as " malignant " by radiological studies. Four false-negative cases by FNA were suspicious for malignancy radiologically. There was no specific pathological subtype associated with false-negative status on FNA in this study. CONCLUSION: Palpable breast tumors can be definitively diagnosed based on a combination of physical examination, radiological studies and FNA, when the radiological studies concur with the diagnosis by FNA.     

Usefulness of thallium-201 SPECT scintimammography to differentiate benign from malignant breast masses in mammographically dense breasts

The purpose of this study was to assess the usefulness of thallium-201 (Tl-201) single-photon emission-computed tomography (SPECT) scintimammography to differentiate benign from malignant breast masses in 32 female Taiwanese patients with indeterminate mammographic probability of malignancy because of mammographically dense breasts. All breast masses were removed, and final histopathological diagnoses were obtained in all cases. The results showed that thallium-201 SPECT scintimammography findings were true-positive in 22 cases, false-positive in 1 case, true-negative in 7 cases, and false-negative in 2 cases. The diagnostic sensitivity, specificity, and accuracy were 91.7%, 87.5%, and 90.6%, respectively, for detecting breast cancer in mammographically dense breasts. In conclusion, thallium-201 SPECT scintimammography is a useful tool for differentiating benign from malignant breast masses in patients with indeterminate mammograms because of mammographically dense breasts.