钼靶X线检查在以钙化为唯一征象的乳腺癌诊断中的价值

Diagnostic value of micro-calcification as the only character in breast cancer by mammography

目的:探讨钼靶X线检查在以簇状微小钙化为唯一征象的乳腺癌诊断中的意义。方法:34例乳腺病变患者先行钙化灶钼靶立体定位,细针穿刺注射美蓝染色,手术切除染色区域,切除标本取材,作冰冻切片及蜡片的病理诊断,比较良、恶性病变钙化的范围、单位面积(cm2)内钙化的数量以及钙化的形态、大小、分布,短期随访钙化数量的变化。结果:34例患者中乳腺癌18例,其中导管原位癌6例,早期浸润性癌4例,局部浸润性癌8例;良性乳腺病变16例。单位面积内钙化的数量:乳腺癌中83.33%>20颗,良性病变中68.75%≤20颗;钙化类型:66.67%恶性病变为混合型,68.75%良性病变为细沙型;44.44%乳腺癌钙化的同时伴有导管分布,良性病变的钙化不伴导管分布;8例进行随访,4例钙化数量增多者均为乳腺癌,2例钙化数量减少者均为良性病变,2例钙化数量不变者,乳腺癌、良性病变各1例。结论:混合型簇状钙化、簇状钙化同时伴有导管分布、单位面积内钙化的数量大于20颗、短期内钙化数量增多,是乳腺癌的特征性钙化征象。

Objective： To discuss the significance of cluster micro-calcification in the diagnosis of breast cancer by mammography. Methods： Thirty-four patients were stained by computer-aid stereotactic mammography and then resected; the resected specimen was sent to pathological department which was marked by a wire under mammography post-operation together with the photo, then compared with the characteristics of micro-calcification between benign lesions and malignant lesions, such as area, number in unit area, shape, size, spatial arrangement and short-time change and so on. Results： In all 34 cases, 18 were breast cancer. 6 cases of these 18 patients were ductal carcinoma in situ （DCIS）, 4 cases were early invasire carcinoma; 8 cases were located invasion, the other 16 cases were benign. In addition, the number of calcification were more than 20 in 83.33% of malignant lesions, and less than or equal to 20 in the 68.75% of benign lesions in unit area. While the multiform calcification were showed in 66.67% of malignant lesions, sand-like calcification were showed in 68.75% of benign lesions, 44.44% of malignancy of microcalcification were along with duct, but no duct along with calcification in benign lesions. In short-time follow-up, increased with the micro-calcification was the appearance of malignancy, and decreased with the micro-calcification was confirmed as the benign lesions. Conclusion： Characteristics of breast cancer as follows： distribution of multiform and cluster of micro-calcification were along with duct, the number of calcification were more than 20 in unit area, and sharply increasing in short-time follow-up.