伴髓样特征乳腺癌的超声图像特征及误诊分析

目的探讨伴髓样特征乳腺癌的超声图像特点及超声误诊原因。 方法回顾性分析2011年1月至2017年1月在常州市第二人民医院乳腺外科经手术及病理证实的24例伴髓样特征乳腺癌患者(共24个病灶)的超声声像图，超声观察指标包括肿块数量、大小、边界、形态、内部回声、后方回声及肿块内部是否伴微钙化、腋下淋巴结受累及肿块内部血流情况。 结果24例伴髓样特征乳腺癌中18例术前超声诊断与术后病理诊断符合，超声诊断准确率为75.0%(18/24)；4例术前超声参照乳腺影像报告和数据系统分级3级，误诊为纤维腺瘤，2例术前乳腺影像报告和数据系统分级5级，误诊为浸润性导管癌。 结论超声检查对伴髓样特征乳腺癌具有较高的诊断准确率，分析其误诊原因有利于进一步提高对本病声像图特征的认识，避免误诊发生。

Ultrasonographic features and misdiagnosis analysis of breast carcinoma with medullary features

ObjectiveTo explore the ultrasonographic features and causes of misdiagnosis of breast carcinoma with medullary features. MethodsThe sonographic appearances and pathological features of breast carcinomas with medullary features in 24 patients(a total of 24 lesions)diagnosed by operation and pathology were analyzed retrospectively. Ultrasonic appearances such as lump quantity, size, boundary, shape, internal echo, rear echo, lump internal microcalcification with or without, lump internal blood stream situation, oxter lymph nodes infiltration information were analyzed. ResultsAmong the 24 cases of breast carcinomas with medullary features, 18 cases preoperative ultrasonic diagnosis were accorded with pathologic diagnosis, ultrasonic diagnosis accurate rate was 75.0%(18/24). Four cases graded BI-RADS 3 by preoperative ultrasound were misdiagnosed as fibroadenoma, 2 cases graded BI-RADS 5 by preoperative ultrasound were misdiagnosed as infiltration ductal carcinoma. ConclusionsUltrasonography has relatively higher diagnostic accuracy in breast carcinoma with medullary features. Analyzing the causes of misdiagnosis may further improve the recognition of ultrasonographic characteristic in breast carcinoma with medullary features, avoiding misdiagnosis.