110例乳腺间期癌的临床病理特征分析

目的 分析顺义区三轮乳腺癌筛查中110例间期癌患者的临床及病理特征。方法 将顺义区历年乳腺癌发病个案信息与北京市妇幼保健网络信息系统中适龄女性乳腺癌筛查数据进行关联，查询乳腺间期癌患者。将间期癌患者与同时期在我院乳腺中心就诊的乳腺癌患者进行特征比较。结果与门诊收治的原发性乳腺癌相比，间期癌患者年龄偏小、超声肿物较小，差异均有统计学意义（P＜0.05）。与病灶大小相近的门诊收治的乳腺癌患者相比，真正间期癌X线检查恶性钙化和浸润性导管癌的比例均较高，差异均有统计学意义（P＜0.05）。间期癌患者在乳腺癌筛查中转诊X线检查比例很低（0.91%），而110例间期癌确诊时有103例接受了乳腺X线检查，其中53例（48.2%）存在恶性钙化表现。结论 乳腺癌筛查中，年龄偏小的女性更易发生间期癌。由于间期癌患者中接近50%在诊断时存在X线下恶性钙化表现，因而若在以超声检查为主的乳腺癌筛查过程中结合乳腺X线检查，或许可以避免部分间期癌的发生。

Clinicopathological characteristics of 110 interval cancer cases in breast cancer screening

Objective To explore the clinical and pathological characteristics of 110 interval cancer cases in first three rounds breast cancer screening of Shunyi District. Methods The breast cancer incidence registration system and the database of breast cancer screening were linked to identify the interval cancer cases. The characteristics of interval breast cancers were compared with breast cancers from the outpatients among the same period. Results Compared with breast cancer outpatients， interval cancer cases were younger and of smaller size on breast ultrasonography（P＜0.05）. Compared with similar size of breast cancer outpatients， true interval cancer cases had significantly higher proportions of malignant calcification on mammography and invasive ductal carcinoma（P＜0.05）. Among the total 110 interval breast cancer cases， only 1 case was assigned to mammography as a referral， and the referral proportion was only 0.91%. In regard to the diagnosis mammography， 53 out of 103 interval cases（48.2%） were characterized by malignant calcification. Conclusion In breast cancer screening， women with younger age are prone to interval cancer. As nearly half of the interval cancer cases contained malignant calcification on diagnostic mammography， breast cancer screening using breast ultrasonography and additional mammography may avoid part of interval cancer cases.