数字化乳腺X线与超声诊断老年乳腺癌钙化的价值

Comparative study on the diagnostic value of mammography and ultrasonography in diagnosis of calcification in elderly patients with breast cancer

目的探讨数字化乳腺X线(乳腺DR)与超声对老年乳腺癌内钙化的诊断价值。方法收集2011年10月至2015年12月收治的年龄>60岁的乳腺DR可见钙化且病理诊断为乳腺癌的124例老年患者的临床资料,将乳腺DR和超声结果进行分析。结果124例老年患者中,乳腺DR诊断钙化伴随肿物者79例,钙化伴随局灶致密者36例,单纯表现为钙化者8例,结构扭曲伴钙化1例;超声检出钙化者108例,超声显示单纯肿物者16例。病理诊断为浸润性导管癌101例,导管内癌14例,小叶癌7例,导管内原位癌2例。乳腺DR诊断BI-RADS 4C以上者120例,符合率为95.16%,彩超诊断BI-RADS4C以上者113例,符合率为91.13%,乳腺X线对有钙化的乳腺癌的检出率高于超声,但差异无统计学意义(P>0.05)。结论乳腺DR诊断老年乳腺癌内钙化的准确性优于超声检查,但是两者诊断乳腺癌的符合率没有明显差异。

Objective To compare the diagnostic value of mammography and ultrasonography in diagnosis of calcification in elderly patients with breast cancer.Methods A total of 124 elderly patients with breast cancer(>60 years)diagnosed by pathological examination and with calcifications by mammography,who were treated in our hospital from October 2011 to December 2015,were enrolled in the study.The examination results by mammography and ultrasonography were statistically analyzed and compared.Results Among the 124 elderly patients,by mammography,there were 79 cases of calcification associated with tumor,36 cases of calcification associated with focal density,8 cases of simple calcification and 1 case of calcification with architectural distortion.However by ultrasonography,there were 108 cases of calcification and 16 cases of tumor.Moreover by pathology,there were 101 cases of infitrating ductal carcinoma,14 cases of intraductal carcinoma,7 cases of lobular carcinoma and 2 cases of ductal carcinoma in situ.By mammography,120 patients were diagnosed as BI-RADS:4C or 5,with the diagnostic coincidence rate being 95.16%.By ultrasonography,113 patients were diagnosed as BI-RADS:4C or 5,with the diagnostic coincidence rate being 91.13%.The detection rate of breast cancer with calcification by mammography was higher than that by ultrasonography,but the difference was not statistically significant(P>0.05).Conclusion The accuracy of mammography in diagnosis of calcification in elderly patients with breast cancer is superior to that by ultrasonography,however,there is no significant difference in the coincidence rate between the two diagnosis methods.