双侧原发性乳腺癌的X线评价与临床对照研究

Evaluation on X-ray and clinic study of bilateral primary breast cancer

目的:早期发现对侧乳腺癌。方法:搜集36例双侧原发性乳腺癌患者的临床、病理及X线资料进行对照分析。结果:(1)20例同时性乳腺癌中19例X线明确诊断双侧原发性乳腺癌。另1例一侧诊断乳腺癌,另一侧误诊为腺体增生。临床诊断双侧原发性乳腺癌8例,另12例未发现乳腺癌。(2)16例异时性乳腺癌中,后发癌中临床11例触及肿物,摄片诊断为乳腺癌;另5例临床未触及肿物,摄片发现乳腺癌。结论:(1)乳腺摄影有助于早期发现对侧原发乳腺癌。(2)临床触不到肿块就不会有癌存在的观念应该改变。(3)双侧乳腺应同时进行X线检查,有利于早期发现病灶。同时为以后对照比较提供资料。

Objective： To detect bilateral breast cancer in the early period. Methods： The clinical and mammography and pathology of 36 patients with bilateral primary breast cancer were analyzed. In these patients, 20 were synchronous bilateral breast cancer, 16 were non-synchronous bilateral breast cancer. Results： （1）19 of 20 synchronous bilateral breast cancer were diagnosed correctly by mammogra- phy . 1 of 20 synchronous bilateral breast cancer was misdiagnosed （one breast was no diagnosed breast cancer , the other was diagnosed hyperplasia）. 8 of 20 synchronous bilateral breast cancer were diag- nosed correctly by clinical palpation.12 of 20 synchronous bilateral breast cancer were misdiagnosed （2） 11 of 16 non-synchronous bilateral breast cancers were palpable and they were diagnosed as cancer by mammography. 5 of 16 non-synchronous bilateral breast cancers were non-palpated tumors , they were diagnosed as cancer by mammography and were proved by pathology. Conclusion： （1）Mammography avail to detect second-primary breast cancer in another breast. （2）The concept that ＂no palpable mass, no cancer＂ should be transformed. （3）Mammography of bilateral breasts should be examined at the same time. It could found early cancer and offer us radiological data for contrasting later.