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目的分析乳腺超声检查和乳腺钼靶检查在乳腺癌筛查中的乳腺影像报告和数据系统(BI-RADS)应用,总结临床随访经验,以期提高该地乳腺癌筛查质量。方法选取2012年5月-2014年11月在该院进行乳腺癌筛查的妇女37 036例为研究对象,经乳腺科临床乳腺检查和分流,其中选择乳腺超声检查15 478例,乳腺钼靶检查21 558例。采用美国放射学会(ACR)提出的BI-RADS第4版和第5版,进行规范化的乳腺影像评估和分类管理,对最终评估为BI-RADS 0类、4类和5类妇女进行临床随访,并进行回顾性分析。结果 15 478例乳腺超声检查妇女,评估为BI-RADS 0类246例,BI-RADS 1~3类15 179例,BI-RADS 4类51例,BI-RADS 5类2例。21 558例乳腺钼靶检查妇女,评估为BI-RADS 0类2 057例,BI-RADS1~3类19 331例,BI-RADS 4类164例(4A类120例,4B类33例,4C类11例),BI-RADS 5类5例。445例临床随访病例中,经手术病理证实为乳腺癌21例,阳性检出率为56.70/10万,失访34例;乳腺超声检查有5例证实为乳腺癌:浸润性导管癌3例,浸润性小叶癌2例(BI-RADS 4类2例,0类3例);乳腺钼靶检查有16例证实为乳腺癌:导管原位癌3例,浸润性导管癌9例,浸润性小叶癌4例(BI-RADS 5类4例,4C类7例,4B类3例,4A类2例)。结论乳腺钼靶检查和乳腺超声检查相结合是最佳的乳腺癌筛查模式,可以提高该地乳腺癌筛查质量。
Objective To analyze the application of Breast Imaging Reporting and Data System (BI-RADS) in breast cancer screening by mammography and mammography, and to summarize clinical follow-up experience in order to improve the quality of breast cancer screening in this area. Methods A total of 37 036 women who underwent breast cancer screening in this hospital from May 2012 to November 2014 were enrolled in this study. According to the clinical mammography and shunt of breast, 15 478 mammograms and mammography 21 558 cases. BI-RADS 4th and 5th editions presented by the American College of Radiology (ACR) were used for standardized mammographic assessment and classification management and clinical follow-up of BI-RADS 0, 4 and 5 women in the final assessment, And a retrospective analysis. Results A total of 15 478 breast ultrasound examinations were performed in 246 women classified as 0 in BI-RADS, 15 179 in BI-RADS 1 to 3, 51 in BI-RADS 4 and 2 in BI-RADS. A total of 21 558 breast mammographic examinations were performed in 2 057 women in BI-RADS category 0, 19 331 in BI-RADS1 and 3, 164 in BI-RADS category 4 (120 in category 4A, 33 in category 4B, 11 cases), BI-RADS 5 cases in 5 cases. Of the 445 clinical follow-up cases, 21 were breast cancer confirmed by surgery and pathology, with a positive rate of 56.70 / 100 000 and 34 patients lost to follow-up. Among the 5 cases confirmed by breast ultrasound examination, 3 were breast cancer: invasive ductal carcinoma, Invasive lobular carcinoma in 2 cases (BI-RADS 4 cases in 2 cases, 0 cases in 3 cases); breast molybdenum target examination in 16 cases confirmed as breast cancer: ductal carcinoma in situ in 3 cases, invasive ductal carcinoma in 9 cases, infiltrating lobular 4 cases of cancer (BI-RADS 5 cases in 4 cases, 4C in 7 cases, 4B in 3 cases, 4A in 2 cases). Conclusion The combination of breast mammography and mammography is the best breast cancer screening model, which can improve the quality of breast cancer screening in this area.