乳腺高危病变的乳腺X线诊断及技术进展

The diagnosis of breast high-risk lesions and technical progress in mammography

乳腺高危病变包括良性病变及原位癌,具有发生乳腺癌的风险。高危病变首诊主要依赖于穿刺活检,但首诊后存在一定的病变升级率。对于不同的高危病变,如不典型导管增生(ADH)、乳头状瘤伴不典型增生、放射状瘢痕、小叶原位癌(LCIS)、不典型小叶增生(ALH)、黏液囊肿样病变、平坦上皮非典型增生等,乳腺X线检查的诊断及处理原则并不完全相同。就乳腺X线检查对高危病变的诊断、处理、预后评估的研究进展予以综述。

High-risk lesions of breast include some benign lesions and carcinoma in situ, and have an increased risk of developing breast cancer. The initial diagnosis of high-risk lesions mainly relies on core needle biopsy, but the lesions can be aggravated after initial diagnosis. For differentiating high-risk lesions, such as atypical ductal hyperplasia, papilloma with atypical hyperplasia, radial scar, lobular carcinoma in situ, atypical lobular hyperplasia, mucinous cystoid lesions, and flat epithelial atypical hyperplasia, the mammographic diagnoses and treatment strategies are not completely the same. This review summarizes the progress of the diagnosis, management and prognosis evaluation of high-risk lesions using mammography.