钼靶X线摄影乳腺癌误漏诊因素分析

Investigation of the molybdenum target X-ray photography misdiagnosis factors of breast cancer

目的探讨钼靶X线摄影乳腺癌误诊因素。方法收集乳腺癌患者102例,就其中漏误诊10例,回顾性分析其钼靶X线征象及漏误诊的原因。结果 10例患者经手术病理证实,左乳癌4例,右乳癌6例。X线表现:肿块型4例,非肿块型6例。漏误诊10例,占9.8%,其中误诊9例,漏诊1例。误诊为增生灶4例,良性占位5例。结论钼靶X线摄影对乳腺癌诊断准确率在90%以上,漏误诊率在10%以下,X线征象不典型、缺乏间接征象、致密型乳腺、照片质量等是致漏误诊的主要原因,任何不对称性局部密度增高、局灶性结构扭曲,较密集的微细钙化均应结合彩色多普勒超声、磁共振成像检查,以减少漏误诊,提高对乳腺癌的诊断准确率。

Objective To explore the molybdenum target X-ray photography misdiagnosis factors of breast cancer. Methods Collecting 102 cases with breast cancer,retrospectively analyze the reasons of misdiagnosis and missed diagnosis of breast cancer in 10 cases. Results Ten cases were confirmed by pathology, left breast cancer in 4 cases,while 6 cases with right cancer. X-ray signs included mass in 4 cases and 6 cases of non-mass breast cancer. In the 10 cases which had been missed or mistaken diagnosed （9.8%）, 9 diagnosis were misdiagnosing and 1 diagnosis were missing, including 4 cases with hyperplasia, 5 cases with benign occupying lesions. Conclusion The diag-nostic accuracy of X-ray photography in breast cancer was over 90%, and the misdiagnosis rate was less than 10%. X-ray signs are atypical, lack of indirect signs, dense breast, photo quality is the main causes of misdiagnosis. Any asymmetry of local increased density , local structure distortion, more dense micro calcification should be combined with color Doppler ultrasound and MRI to reduce misdiagnosis, improve the accuracy of diagnosis of breast cancer.