早期乳腺癌的X线表现(附40例报告)

Mammographic Manifestations of Early Breast CancerA Report of 40 Cases

目的 提高对早期乳腺癌X线征象的认识。材料与方法 将 40例早期乳腺癌X线征象作回顾性分析。结果 早期乳腺癌X线征象有 :泥沙样微细钙化 3 0例 ( 75 % ) ,X线未见肿块或结节而钙化灶为唯一恶性征象者 18例 ( 4 5 % ) ,与对侧乳房比较呈不对称局限性密度增高 15例 ( 3 7.5 % ) ,致密小结节影 14例 ( 3 5 % ) ,乳腺结构局部扭曲紊乱 4例 ( 10 % ) ,条索状导管增粗 5例( 12 .5 % ) ,血管影迂曲、增多、增粗 1例 ,无异常X线征显示 1例。结论 ( 1)泥沙样微细钙化仍是早期乳腺癌非常重要的诊断依据 ,甚至是唯一恶性征象。 ( 2 )非对称性局限性密度增高 ,乳腺结构局部扭曲紊乱 ,在排除乳腺炎和手术穿刺活检病史后 ,应考虑早期乳腺癌可能。 ( 3 )在串珠型结节样乳腺中混杂着的恶性致密小结节影 ,易被忽视 ,须与健侧乳腺仔细对照观察 ,以发现小癌或微小癌。 ( 4 )对临床疑为小纤维腺瘤 ,如果X线征有边缘模糊或小角状突起时 ,应予高度重视 ,进行活检。

Objective To improve the understanding of the X ray features of early breast cancer.Materials and Methods The mammographic manifestations of 40 patients with early breast cancer were retrospectively analyzed.Results The X ray signs were as follows: (1) sand like microcalcifications (n=30, 75%), with it being the only X ray finding in 18 cases (45%); (2) localized increased density compared with the normal breast (n=15, 37.5%); (3) dense nodules (n=14, 35%); (4) localized tortuosity or disturbance of mammary gland architecture (n=4,10%); (5) dilated mammary duct (n=5, 12.5%); (6) increased tortuous and dilated vessels (n=1); and (7) no abnormal signs (n=1).Conclusion (1) Microcalcification is a very important X ray sign for diagnosing early breast cancer, sometimes it is the only sign of malignancy. (2) Early breast cancer should be considered when asymmetrical and localized increased densities are present and no history of mastitis or biopsy exists. (3) The malignant dense nodules mixed in beading nodular gland tend to be neglected, one should compare the diseased breast with the normal one in order to detect tiny tumor lesions. (4) Biopsy should be carried out when a small fibroadenoma is suspected clinically and the border of the nodule is hazy or spiculated on mammograms.