临床体检与超声检查在乳腺疾病筛查中的应用

Breast examination combined with ultrasonography in breast disease screening

目的了解不同乳腺疾病的患病现状，探讨乳腺癌发生的可能的高危因素以及乳腺临床检查与超声诊断技术在乳腺病筛查中的意义。方法采用临床体检及乳腺超声对兰州市16223名妇女进行乳腺疾病筛查，同时进行问卷调查，体检女性年龄／〉35岁及乳腺触诊异常或乳腺超声提示3级或以上则行乳腺钼靶检查，非哺乳期乳头溢液患者行乳导管镜检查，乳腺超声或乳腺钼靶提示可疑恶性病灶行空芯针穿刺病理检查以确诊。结果筛查对象中乳腺增生检出率为52．7％，乳腺纤维腺瘤检出率为1．0％，乳腺癌12例（74．0／10万）；40—59岁为乳腺癌发病高峰年龄段；乳腺癌的发生可能与患者年龄、有乳腺癌家族史、月经初潮年龄c：12岁、未哺乳、使用雌激素类药物、高脂饮食、既往乳腺疾病史等因素有关，乳腺超声的筛查阳性率较手诊阳性率i写。结论乳腺普查中应用临床体检结合影像学检查是发现乳腺疾病及早期乳腺癌的有效手段。

Objective To obtain prevalence data of breast diseases in Lanzhou, to explore risk factors of breast cancer, and to examine the significance for breast disease screening by clinical breast examination and ultrasonography. Methods A general investigation was performed on 16 223 women in Lanzhou by questionnaire, clinical breast examina- tion, ultrasonography, or mammography, ductal fiberscopy and core needle biopsy when necessary. Results Mammary gland hyperplasia was found in 52.7 % and breast fibroadenoma in 1.0 % of women examined. Breast carcinoma was found in 12 cases, resulting in a prevalence of 73.96 per 100,000. Risk factors of breast carcinoma were ~ge, family histo- ry of breast carcinoma, menarche younger than 12 years, no lactation, use of hormone replacement therapy, high fat diet, and history of breast diseases. The detection rate of breast diseases by uhrasonography was higher than clinical breast exam- ination. Conclusion The clinical breast examination combined with ultrasonography was effective in screening breast diseases including breast carcinoma.