年轻女性乳腺癌患者的影像学特点

Imaging features of breast cancer in young women

目的观察年轻女性乳腺癌的临床病理特点及影像学表现。方法分析2007年12月—2008年12月经病理证实并具有完整临床资料的40例年轻女性乳腺癌患者(年龄≤35岁),均接受乳腺X线、超声检查。结果 41个病变,包括浸润性导管癌37个(其中伴广泛导管内癌7个),导管内癌1个,其他类型癌3个;其中23个病变(23/41,56.10%)伴淋巴结转移。对40个病灶进行受体检测,ER、PR阴性率分别为32.50%(13/40)、27.50%(11/40),Her-2阳性率为67.50%(27/40)。X线片显示27个病灶(27/41,65.85%)存在钙化;41个病灶中,18个(18/41,43.90%)表现为肿块伴钙化,9个(9/41,21.95%)单纯钙化,6个(6/41,14.63%)单纯肿块,4个结构扭曲(4/41,9.76%),4个病灶(4/41,9.76%,均见于致密型乳腺)影像学无异常表现。X线诊断敏感度为85.37%(35/41),超声诊断敏感度为100%(41/41)。结论钙化是年轻患者乳腺癌最常见的X线征象。对于有症状的年轻女性患者应首选超声检查,而X线有助于进一步观察病变特征。

Objective To explore clinicopathological and imaging features of breast cancer in young women. Methods Totally 40 women aged ≤35 years who underwent mammography and ultrasound and diagnosed as breast cancer from December 2007 to December 2008 were retrospectively reviewed. Results Totally 41 lesions were found, including 37 invasive ductal carcinomas （7 with extensive ductal carcinoma in situ [DCIS]）, 1 DCIS and 3 tumors of other types. Lymph node metastases were found in 23 lesions （23/41, 56.10%）. Receptor detection as performed in 40 lesions, and negative expression of ER and PR was 32.50% （13/40） and 27.50% （11/40）, respectively, while positive expression of Her-2 was 67.50% （27/40）. On mammography, calcification was found in 27 lesions （27/41, 65.85%）. Mammographic manifestations included mass with calcification in 18 lesions （18/41, 43.90%）, pure calcification in 9 （9/41, 21.95%）, mass in 6 （6/41, 14.63%）, architectural distortion in 4 （4/41, 9.76%）, whereas no abnormality in 4 （4/41, 9.76%, all occurred in dense breast）. The sensitivity of mammography and ultrasound in diagnosis of breast cancer was 85.37% （35/41） and 100% （41/41）, respectively. Conclusion Calcification is the most common mammographic feature of breast cancer in young women. Ultrasound may be an appropriate initial imaging method for symptomatic young women, and mammography is useful in further observation on imaging features of breast cancer.