目的探讨青年人乳腺癌的数字乳腺X线与病理表现特点。方法回顾性对比分析105例青年乳腺癌患者和300例中老年乳腺癌患者的数字X线表现及病理结果。结果青年组与中老年组乳腺癌均以Ⅱ级浸润性导管癌为主,外上象限好发。青年组60.95%乳腺癌为肿块型,以<3 cm的肿块为主,36.19%呈非对称致密影,2.86%为单纯钙化;20.95%乳腺癌呈浸润性生长,21.90%可见毛刺,32.38%可见分叶,22.86%结构扭曲,毛刺发生率低于中老年组(χ2=8.331,P=0.004),两组间分叶发生率无明显差别(χ2=2.255,P=0.133)。青年组72.38%乳腺癌可见钙化,以细小多形性钙化、成簇分布为主。肿块型与非肿块型钙化形态及分布差异均有统计学意义(χ2=17.513,P=0.002;χ2=17.965,P=0.000)。乳腺癌雌激素受体(ER)与孕激素受体(PR)、人类表皮生长因子受体-2(HER-2)表达有相关性(r=0.940,P=0.000;r=0.261,P=0.007),ER阳性率低于中老年组,Her-2阳性率高于中老年组。两组间Ⅱ级浸润性导管癌ER、PR阳性率均高于III级浸润性导管癌。青年组Ki-67增殖指数3%~90%,≤5%4例,5%~30%27例,≥30%74例,Ki-67增殖指数大于30%的病例数百分比高于中老年组。两组分子分型均以Luminal B型为主,青年组HER-2过表达型及三阴型乳腺癌发病率均高于中老年组,淋巴结转移率高于中老年组。结论青年人乳腺癌特点为肿块直径多<3 cm,钙化发生率高,组织学分级以Ⅱ级浸润性导管癌为主,病理分子分型以Luminal B型为主,数字乳腺X线摄影检查仍是青年人乳腺癌较佳的检查方法。 Objective To investigate the characteristics of digital mammography and pathology in young people with breast cancer. Methods Retrospectively analyzed the digital radiographic findings and pathological findings of 105 cases of young patients with breast cancer and 300 cases of middle-aged and elderly patients with breast cancer. Results Both young and middle-aged patients with breast cancer were mainly grade Ⅱ invasive ductal carcinomas, with the exception of the upper quadrant. In the youth group, 60.95% breast cancer was mass type, with mass less than 3 cm, 36.19% asymmetric dense shadow, 2.86% pure calcification, 20.95% breast cancer with invasive growth, 21.90% visible burr and 32.38% visible There was no difference between the two groups (χ2 = 2.255, P = 0.133). There was no significant difference in the incidence of lobes between the two groups (χ2 = 2.255, P = 0.133). 72.38% of youth group showed calcification of breast cancer, with small pleomorphic calcification, mainly in clusters. There were significant differences in the shape and distribution of lumps and non-lump calcifications (χ2 = 17.513, P = 0.002; χ2 = 17.965, P = 0.000). The expression of ER, PR and EGFR in breast cancer was correlated (r = 0.940, P = 0.000; r = 0.261, P = 0.007). The positive rate of ER was lower than that of the middle-aged group, and the positive rate of Her-2 was higher than that of the middle-aged group. The positive rates of ER and PR in grade II invasive ductal carcinoma were higher than those in grade III invasive ductal carcinoma. Proliferation index of Ki-67 in young group was 3% ~ 90%, 4 cases were less than 5%, 27 cases were 5% ~ 30%, 74% ≥30%, the percentage of cases with Ki-67 proliferation index greater than 30% . Luminal type B was the main type in both groups. The incidence of HER-2 overexpression and triple-negative breast cancer in young group were higher than those in middle-aged group, and the rate of lymph node metastasis was higher than that of middle-aged and elderly group. Conclusion The characteristics of breast cancer in young people are that the mass of the tumor is more than 3 cm, the incidence of calcification is high, the histological grade is mainly grade Ⅱ invasive ductal carcinoma, and the pathological molecular type is Luminal B type. The digital mammography still Breast cancer is a better way for young people to check.