特殊类型乳腺癌的X线征象分析

Mammographic of special type breast carcinoma

目的探讨特殊类型乳腺癌的X线特征以提高该类疾病的术前诊断水平。方法回顾性分析经手术病理证实、有完整乳腺X线资料的特殊类型乳腺癌54例,观察不同类型乳腺癌的X线特点。结果多数粘液癌表现为类圆形边缘比较光滑肿块(10/16),密度比较高,部分可见毛刺、分叶(5/16)等浸润性生长的特点;髓样癌中多表现类圆形高密度肿块(6/9),钙化少见(2/9),部分可见晕环(4/9);炎性乳腺癌表现多与急性炎症相似,结构紊乱,皮肤增厚,多数未见明确肿块(4/7);乳头状癌多为类圆形肿块,可见细颗粒钙化,其中2例导管造影可见导管内充盈缺损;Paget’s病均有钙化(7/7),部分乳头乳晕区破损溃烂(3/7);伴神经内分泌癌均表现不规则肿块(4/4),可见短毛刺征象;筛状癌多为类圆形肿块(3/4),未见明确钙化。结论乳腺X线摄影检查是诊断乳腺癌的重要手段,特殊类型乳腺癌各有其X线特点,明确这些特征是正确诊断的关键。

Objective To explore the X-ray features of special type breast carcinoma,to improve the level of preoperative diagnosis of these disease. Methods A retrospective analysis was made on 54 cases of special types of breast cancer confirmed by surgery pathology,had full breast X-ray data,and the X-ray features of different types of breast carcinoma were observed.Results Most of mucinous carcinoma showed huge masses with clear margins（ 10 /16）. The density was higher,partly masses were found burrs or leaves which was the characteristics of the invasive growth（ 5 /16）; most of medullary carcinoma showed circular masses（ 6 /9）.These masses showed high density,with less calcification（ 2 /9）. Partly masses were found dizzy ring（ 4 /9）; inflammatory breast carcinoma performance more similar to acute mastitis,the type showed structure disorder,skin thickening and most did not see clear mass（ 4 /7）; most of papillary carcinoma showed ovoid mass,with fine granular calcification,and 2 cases catheter angiography were found intraductal filling defect; all of Paget＇s disease had calcification（ 7 /7）,part of nipple areola area showed damage to fester（ 3 /7）; most of neuroendocrine carcinoma presented irregular mass（ 4 /4）,with short burr sign; most of cribriform carcinoma showed ovoid mass（ 3 /4）,and without clear calcification. Conclusion Mammography is an important method for diagnosis of breast cancer,special types of breast cancer have their respective X-ray characteristics,and to clear these characteristics is the key to the correct diagnosis.