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目的探讨超声检查及定位在中国妇女致密型乳腺发生的早期乳腺癌筛查中的作用。方法对2 0 0 2年2月—2 0 0 6年4月来湘雅医院乳腺科门诊就诊及体检中心健康检查的5万余名女性行乳腺高频超声检查,筛查出乳腺肿块4 0 0 0余例,其中经手术病理证实的致密型乳腺患者乳腺癌1 4 2例(肿块最大横径均≤2 cm),将患者的超声检查与钼靶片结果资料进行分析对比。结果在1 4 2例致密型乳腺的乳腺癌患者中,超声发现微小钙化4 7例(3 3.1 0%),敏感性达7 4.6 0%,准确率为8 8.7 3%;钼靶发现泥沙样钙化3 8例(2 6.7 6%),敏感性6 0.3 2%,准确率为8 2.3 9%。钙化灶的检出率为4 4.3 7%。其中超声发现微小肿块1 1 0例(7 7.4 6%),敏感性8 8.7 1%,准确率为9 0.1 4%;钼靶片发现1 0 0例(7 0.4 2%),敏感性8 0.6 5%,准确率为8 3.1 0%。1 2例临床上未扪及肿块患者均在超声定位下准确地切除病灶。结论(1)高频超声检查在中国妇女致密型乳腺的乳腺癌筛查中检出小肿块及恶性钙化的敏感性以及准确率要高于钼靶片检查。(2)高频超声检查可作为年青妇女、致密型乳腺以及扁平型乳腺早期乳腺癌筛查的有效方法之一,它不仅提高早期乳腺癌的诊断率也提高了保乳率,值得推广使用。
Objective To investigate the role of ultrasonography and localization in the screening of early stage breast cancer in Chinese women with dense breast. Methods February 2002 February 2006 to 2009 Xiangya Hospital Breast Clinic clinic and physical examination of the health examination of more than 50,000 women underwent high-frequency breast ultrasound screening of breast tumors 40 One hundred and twenty cases of breast cancer were confirmed by pathology. One hundred forty-two cases of breast cancer were confirmed by pathology (the largest transverse diameter of tumor was ≤2 cm). The results of ultrasonography and mammography were analyzed. Results Among 142 cases of breast cancer with compact breast, 40 (3/31 0%) were found to be microcalcifications with a sensitivity of 7.460% and an accuracy rate of 8.78% 38 cases of calcification (2 6.76%), sensitivity 6 0.3 2%, the accuracy rate of 8 2.3 9%. The detection rate of calcification was 4 4.3 7%. One hundred and ten cases (7 7.46%) were detected by ultrasonography, the sensitivity was 8.71% and the accuracy rate was 9 0.1 4%. One hundred and ten cases (7 0.4 2%) were found on the molybdenum target and the sensitivity was 8 0.6 5%, the accuracy rate of 8 3.1 0%. One hundred and twenty-two cases of patients with clinically palpable masses were accurately removed the lesions under ultrasound localization. Conclusions (1) High-frequency ultrasonography in breast cancer screening of Chinese women with dense breasts detected the sensitivity of small lumps and malignant calcification as well as the accuracy rate was higher than the molybdenum target film examination. (2) High-frequency ultrasonography can be used as an effective method for screening young women, compact breast and flat breast early breast cancer. It not only improves the diagnosis rate of breast cancer but also enhances the breast-conserving rate, which is worth promoting.