Segmentation Method of Breast Masses on Ultrasonographic Images Using Level Set Method Based on Statistical Model

It is important to segment mass region accurately in a computer-aided diagnosis (CADx) scheme for evaluating the likelihood of malignancy of the mass on ultrasonographic breast image. The purpose of this study was to develop a novel level set method for segmentation of breast mass on ultrasonographic image. Our database consisted of 151 ultrasonographic images with 70 malignant and 81 benign breast masses. In a novel level set method, an energy function was defined with region-based, edge-based, and regularizing terms. The region-based term analyzed global information, whereas the edge-based term analyzed local information. The regularizing term also controlled the length of the boundary curve. The region of breast mass was segmented so that the energy based on those terms was minimized. With our proposed method, true positive (TP) ratio, false positive (FP) ratio, jaccard similarity (JS), and Dice similarity coefficient (DSC) were 92.2%, 9.1%, 84.2%, and 91.3%, respectively. These results tended to be substantially higher than those with two conventional segmentation methods. Our proposed method based on the novel level set method was shown to segment mass region accurately on ultrasonographic breast image.

Evaluation of Breast Masses Using Mammography and Sonography as First Line Investigations

Purpose: To study the specificity of mammography and ultrasonography separately and in combination for detection of breast masses (ultrasonography-mammography correlation);To study the investigations to evaluate various breast masses;To describe suitable indications, advantages and limitations of each technique compared with other available modalities;To study the mimics of breast masses;To have histopathology follow-up and retrospective evaluation with imaging findings to improve diagnostic skills in series of 166 patients complaining of breast mass. Material: The prospective clinical study was carried out in the department of Radiodiagnosis for a period of 2 year extending from December 2010 to December 2012 infemale patients complaining of breast mass. Well informed written consent was obtained from them. Histopathology follow up was obtained from either biopsy or post operative tissue. USG machine: Philips HD 11 XE USG of the breasts and axillary region done in supine position in presence of female attendant;Mammography machine: Allengers machine with Agfa special mammography cassettes. Cranio caudal and Medio-Lateral Oblique views are taken in the presence of female attendant. MRI: PHILIPS 1.5 T machine;CT: SIEMENS duel slice CT machine. Results: Ultrasonography and mammography was done in most of the cases were sufficient to diagnose the lesion in most of the cases especially in benign breast masses. MRI and CT scan was used in special cases to know the extent of the lesions, in mimics of breast masses, bony extensions, primary muscular and bony lesions. Total 166 patients complaining of breast mass in one or both breasts were examined and evaluated with USG and mammography. The lesions were confirmed on histopathology (FNAC/biopsy). Out of 30 diagnosed malignancies two lesions were missed on mammography and four lesions were missed on ultrasonography. One of them was missed on both. For malignancies specificity of mammography is 93.3% and that of ultrasonography is 86.67%. Combining both the modalities specificity is near 97%. Out of total 92 abnormal breasts 12 were missed on USG and 20 were missed on mammography. Combining both the modalities only 2 lesions were missed and were diagnosed on histopathology alone. Overall specificity for USG in breast masses is 86.9% and for mammography it is 78.6%. Combining both the modalities the specificity is 97.6%. The “p” value is obtained which is highly significant for combination of ultrasonography and mammography in comparison with any individual modality (p = 0.0059 & p = 0.0001 respectively). Conclusion: Our study confirms the higher combined sensitivity rate for ultrasonography and mammography for detection of breast masses including malignancies. USG is useful in cystic lesions, ectasias, infections, pregnancy-lactation, and dense breast evaluation and for image guidance, whereas mammography is useful in detecting microcalcifications, spiculated masses for early detection of malignancies and for stereotactic biopsies. To suggest single modality, ultrasonography is better in younger population and BIRAD 1, 2 & 3 lesions. Whereas, mammography is better in older population and BIRAD 4 & 5 lesions. However, sono-mammographic correlation is best in both.

Complex Cystic Breast Masses: An Ultrasound Imaging Review

Cystic lesions are very commonly encountered entities in the breast. Among these, Complex Cystic Breast Masses (CCBMs), which contain both anechoic and echogenic components, can result in a variety of imaging appearances. These include cystic lesions with thick walls and/or internal septa, intracystic nodular lesions, and solid-cystic masses of varying compositions. Ultrasound is the mainstay for evaluating cystic lesions, and thus recognizing the imaging features appropriately and suggesting suitable interventional procedures are included in their management. In this pictorial essay, we describe the wide range of ultrasound appearances of CCBMs with a number of clinically encountered examples from our institution. This article would enhance the understanding of readers in possible differentials to be included in their clinical practice and to suggest appropriate further intervention, when deemed necessary.

The Role of RNA Epitranscriptomics and the RNA Fat Mass and Obesity-Associated Demethylase in Triple Negative Breast Cancer

Breast cancer is one of the most commonly diagnosed cancers and one of the most significant sources of cancer mortality. Triple negative breast cancer (TNBC) is a particularly aggressive subtype that has proven difficult to treat with standard chemotherapies. Obesity has also been shown to exacerbate breast cancer, and diagnoses of these two diseases frequently overlap. Both conditions are regulated in part by the fat mass and obesity-associated (FTO) demethylase, an RNA demethylase which may drive breast cancers through epigenetic alterations to gene expression. Methods of inhibiting FTO have been researched in vitro and in vivo as an alternative or adjunct to chemotherapies in multiple cancers, including breast cancer. Translating knowledge of the role of FTO in breast cancer and the development of novel agents may allow for improvements in the treatment of this refractory cancer. This review therefore aims to provide an overview of existing and developing chemical inhibitors of FTO that could be innovatively studied for the treatment of TNBC and associated comorbidity.

Surrounding electroacupuncture needling for breast mass after acute mastitis

Objective： To observe the clinical efficacy of surrounding electroacupuncture needling for breast mass after acute mastitis.Methods： Thirty patients with breast mass after acute mastitis who conformed to the inclusion criteria were given surrounding electroacupuncture needling. Acupoint selection： 4-8 needles were needled around the mass and at Zusanli（足三里ST 36）,Sanyinjiao（三阴交SP 6）,Fengl6 ng（丰隆 ST 40） and Rugen（乳根 ST 18）. Electroacupuncture was performed at ST 36, SP 6 and ST 40. The above treatment was once a day. Treatment for 7 times was considered as 1 course of treatment, and 3 weeks were free from treatment between courses. Color ultrasound in breast was used to examine the breast mass before the next course of treatment, treatment can be terminated if the mass disappeared, otherwise, treatment should be continued. Three courses at most were needed.Results： After 1-3 courses of treatment, 16 patients were cured, accounting for 53.3%（16/30）; markedly effective： 8 cases, accounting for 26.7%（8/30）; effective： 4 cases, accounting for 13.3%（4/30）; ineffective：2 cases, accounting for 6.7%（2/30）.Conclusion： Surrounding electroacupuncture needling for breast mass after acute mastitis was effective clinically.

Body Mass Index and Breast Cancer Risk: A Retrospective Multi-Institutional Analysis in Saudi Arabia

Background: The purpose of this study was to evaluate the association between the body mass index (BMI) of breast cancer patients and non-cancer females of the Eastern Province of Saudi Arabia. Methods: The weight, height and age was obtained from the patient records of 706 newly diagnosed breast cancer patients and of 20,872 non-cancer female patients who consulted the two largest hospitals in the Eastern Province of Saudi Arabia between 2006 and 2012. Factorial analysis of variance (ANOVA) was used to assess the association between the BMI, age and breast cancer status. Results: The mean BMI of the non-cancer females was 29.4 and the percentage of obese patients of the different age groups ranged from 23.9% to 66.5%. The BMI increased significantly with age. The ANOVA revealed that breast cancer patients older than 50 years had a significantly lower BMI compared to their non-cancer counterparts (p = 0.01). Conclusion: Our data confirm the high BMI of the Saudi Arabian female population. The reason for our finding of a lower BMI of postmenopausal breast cancer patients compared to their non-cancer counterparts is unclear. Future studies are warranted to assess the impact of possible confounding factors on the association between obesity and breast cancer risk. An interesting factor to investigate in future studies would particularly be the use of the anti-diabetic and cancer-protective drug metformin considering that diabetes mellitus is endemic in Saudi Arabia with a prevalence of 30%.

The Effect of Body Mass Index on Survival in Breast Cancer

Background: Obesity is a well-known risk factor for breast cancer recurrence and poor prognosis. The objective of this study was to evaluate the effect of body mass index (BMI) on survival in breast cancer patients. Methods: We performed a retrospective analysis of 50 breast cancer patients treated in our hospital from January 2012 to December 2013. Patients were divided according to body mass index when diagnosed into: normal weight BMI 25 Kg/m2, over weight BMI ≥ 25 Kg/m2 to 2, obesity BMI ≥ 30 Kg/m2. In this study the effect of body mass index on progression free survival (PFS) and overall survival (OS) was evaluated. Results: The disease free survival (DFS) and overall survival (OS) decreased in overweight and obese patients. Both overweight and obesity were predictors for increased risks of breast cancer relapse and mortality with a median disease free survival for overweight 29 mons and obese patients 11 mons and a median overall survival for overweight patients 49 mons and obese patients 39 mons. Conclusion: Obesity and overweight are associated with poorer disease free survival and overall survival in patients with breast cancer.

Analysis of Machine Learning Techniques Applied to the Classification of Masses and Microcalcification Clusters in Breast Cancer Computer-Aided Detection

Breast cancer is one of the most common and deadliest types of cancer among women and early detection is of major importance to decrease mortality rates. Microcalcification clusters and masses are two major indicators of malignancy in the early stages of this disease, when mammography is typically used as the screening technology. Computer-Aided Diagnosis (CAD) systems can support the radiologists’ work, by performing a double-reading process, which provides a second opinion that the physician can take into account in the detection process. This paper presents a CAD model based on computer vision procedures for locating suspicious regions that are later analyzed by artificial neural networks, support vector machines and linear discriminant analysis, to classify them into benign or malignant, based on a set of features that are extracted from lesions to characterize their visual content. A genetic algorithm is used to find the subset of features that provide the greatest discriminant power. Our results show that the SVM presented the highest overall accuracy and specificity for classifying microcalcification clusters, while the NN outperformed the rest for mass-classification in the same parameters. Overall accuracy, sensitivity and specificity were measured.

Breast non-mass-like lesions on contrast-enhanced ultrasonography: Feature analysis, breast image reporting and data system classification assessment

BACKGROUND Breast non-mass-like lesions(NMLs)account for 9.2%of all breast lesions.The specificity of the ultrasound diagnosis of NMLs is low,and it cannot be objectively classified according to the 5th Edition of the Breast Imaging Reporting and Data System(BI-RADS).Contrast-enhanced ultrasound(CEUS)can help to differentiate and classify breast lesions but there are few studies on NMLs alone.AIM To analyze the features of benign and malignant breast NMLs in grayscale ultrasonography(US),color Doppler flow imaging(CDFI)and CEUS,and to explore the efficacy of the combined diagnosis of NMLs and the effect of CEUS on the BI-RADS classification of NMLs.METHODS A total of 51 breast NMLs verified by pathology were analyzed in our hospital from January 2017 to April 2019.All lesions were examined by US,CDFI and CEUS,and their features from those examinations were analyzed.With pathology as the gold standard,binary logic regression was used to analyze the independent risk factors for malignant breast NMLs,and a regression equation was established to calculate the efficiency of combined diagnosis.Based on the regression equation,the combined diagnostic efficiency of US combined with CEUS(US+CEUS)was determined.The initial BI-RADS-US classification of NMLs was adjusted according to the independent risk factors identified by CEUS,and the diagnostic efficiency of CEUS combined with BI-RADS(CEUS+BI-RADS)was calculated based on the results.ROC curves were drawn to compare the diagnostic values of the three methods,including US,US+CEUS,and CEUS+BI-RADS,for benign and malignant NMLs.RESULTS Microcalcification,enhancement time,enhancement intensity,lesion scope,and peripheral blood vessels were significantly different between benign and malignant NMLs.Among these features,microcalcification,higher enhancement,and lesion scope were identified as independent risk factors for malignant breast NMLs.When US,US+CEUS,and CEUS+BI-RADS were used to identify the benign and malignant breast NMLs,their sensitivity rates were 82.6%,91.3%,and 87.0%,respectively;their specificity rates were 71.4%,89.2%,and 92.9%,respectively;their positive predictive values were 70.4%,87.5%,and 90.9%,respectively;their negative predictive values were 83.3%,92.6%,and 89.7%,respectively;their accuracy rates were 76.5%,90.2%,and 90.2%,respectively;and their corresponding areas under ROC curves were 0.752,0.877 and 0.903,respectively.Z tests showed that the area under the ROC curve of US was statistically smaller than that of US+CEUS and CEUS+BI-RADS,and there was no statistical difference between US+CEUS and CEUS+BI-RADS.CONCLUSION US combined with CEUS can improve diagnostic efficiency for NMLs.The adjustment of the BI-RADS classification according to the features of contrastenhanced US of NMLs enables the diagnostic results to be simple and intuitive,facilitates the management of NMLs,and effectively reduces the incidence of unnecessary biopsy.

Novel Approach for Quantitative Measurement of Matrix Metalloprotease-1 (MMP1) in Human Breast Cancer Cells Using Mass Spectrometry

Identification and quantification of low abundance growth factors and regulators in complex biological samples still present a challenging task in analytical biochemistry. Immunoassays are often used for such purpose but immunoassays face limitation of both availability and qualities of antibody reagents that are necessary for development of immune assays. With genomics data base available, mass spectrometry (MS) can analyze protein tryptic peptides directly for quantitative determination of proteins. In this study, we report a method for detection of matrix metalloproteinase 1 (MMP1), an important extracellular matrix modulator, in human breast cancer cells by quadrupole time-of-flight (Q-TOF) MS. Absolute quantification of MMP1 was conducted using the selected reaction monitoring (SRM) on a triple quadrupole (Triple-Quad) MS via transitions selected from MMP1 tryptic peptides using non isotope labeled MMP1 protein as a titration standard. In comparison with immune based assay, this MS method showed picogram level sensitivity for quantitative determination of MMP1 intotal cell lysates. Our results demonstrated the feasibility of absolute quantification of low abundance proteins using label-free protein standard by mass spectrometry. Therefore, this method provides not only advantages of high sensitivity but also cost saving in comparison with the commonly used mass spectrometry that currently employs isotype labeled proteins for quantitative analysis.

GZMB在乳腺癌和乳腺良性肿物患者中的表达及与T淋巴细胞水平的关系研究

目的:探讨颗粒酶B(granzyme B,GZMB)在乳腺癌和乳腺良性肿物患者中的表达及与T淋巴细胞水平的关系。方法:选取2022年1月至2023年8月南阳市第一人民医院收治的乳腺癌患者63例为观察组,根据肿瘤分期分为T_(1)N_(0)M_(0)组、T_(2)N_(0)M_(0)组、T_(2)N_(1)M_(0)组、T_(3)N_(0)M_(0)组及T_(3)N_(1)M_(0)组;选择同期治疗的乳腺良性肿物患者9例为对照组;采用流式细胞仪测定各组GZMB及T淋巴细胞水平;对乳腺癌患者GZMB与T淋巴细胞参数完成相关性分析。结果:观察组乳腺癌患者GZMB水平高于对照组(P<0.05);CD_(3)^(+)、CD_(4)^(+)及CD_(4)^(+)/CD_(8)^(+)水平低于对照组(P<0.05);乳腺癌不同分期下CD_(8)^(+)水平无统计差异(P>0.05);乳腺癌患者中T_(3)N_(1)M_(0)组GZMB水平高于其余4组(P<0.05),CD_(3)^(+)、CD_(4)^(+)及CD_(4)^(+)/CD_(8)^(+)水平低于其余4组(P<0.05);乳腺癌患者分期越高,GZMB水平越高,CD_(3)^(+)、CD_(4)^(+)及CD_(4)^(+)/CD_(8)^(+)水平越低;Pearson相关性结果表明,乳腺癌患者GZMB水平与CD_(3)^(+)、CD_(4)^(+)及CD_(4)^(+)/CD_(8)^(+)水平呈负相关(P<0.05)。结论:GZMB在乳腺癌患者中呈高表达,其表达水平在不同分期中存在差异,且与T淋巴细胞水平存在相关性,可指导临床诊疗。

合成MRI联合弥散加权成像及DCE-MRI在鉴别乳腺BI-RADS 4类肿块良恶性的价值分析

目的:探讨合成磁共振成像(syMRI)联合弥散加权成像(DWI)、动态对比增强磁共振成像(DCE-MRI)在鉴别乳腺成像报告和数据系统(BI-RADS)4类肿块良恶性的价值。方法:回顾性分析2022年1月—2024年1月本院80例患者98个BI-RADS 4类肿块病变的syMRI、DWI和DCE-MRI图像,所有患者均经穿刺活检或手术获得病理结果(51个恶性病变,47个良性病变),测量表观扩散系数(ADC)、弛豫时间值(T_(1)、T_(2))和质子密度值(PD),采用logistic回归建立弛豫定量模型、基于DE-MRI的BI-RADS模型,基于弛豫定量参数联合ADC以及BI-RADS建立联合诊断模型,受试者工作特性(ROC)曲线下面积(AUC)评估各模型诊断效能。结果:logistic回归显示ΔT_(1)%(OR=1.512)、T_(2)(OR=6.907)可构建弛豫定量模型,时间—信号强度曲线类型(TIC)(OR=2.464)可构建BI-RADS模型,ΔT_(1)%、T_(2)、ADC、TIC构建联合诊断模型,联合诊断模型诊断AUC为0.874,显著高于弛豫定量模型0.768和BI-RADS模型0.644,差异均具有统计学意义(P<0.05)。结论:syMRI联合DWI定量参数和DCE-MRI可以提高BI-RADS 4类肿块的诊断效能,是区分乳腺BI-RADS 4类结节良、恶性的一种很有前途的诊断方法。

自制乳腺肿物模型训练法在超声导丝定位穿刺实践教学中的效果评价

目的探究自制乳腺肿物穿刺模型在临床超声介入教学中的应用效果。方法选取2021年1月—2022年12月黑龙江中医药大学附属第二医院超声影像学专业及康复医学专业的50名规培生为研究对象,按照不同规培时间将其分为研究组和对照组,每组25名,其中对照组规培时间为2021年1—12月,研究组规培时间为2022年1—12月。对照组规培生予传统教学法,即课堂理论教学结合高强度琼脂乳腺教学模型进行训练;研究组规培生在课堂理论教学的基础上再结合自制乳腺肿物模型实操训练;待学习结束后统一对两组规培生进行理论及实践考核以及学习满意度调查,比较对照组及研究组的学习结果。结果两组规培生的理论考核成绩差异比较,差异无统计学意义(P>0.05)。研究组规培生的操作考核成绩明显高于对照组学生,差异有统计学意义(P<0.05)。研究组规培生在增强操作技能、激发理论兴趣、丰富教学内容等各个方面评分均有较高的满意度,且显著高于对照组,差异有统计学意义(P均<0.05)。结论自制乳腺肿物穿刺模型能使学生更好地将超声介入技术应用于今后的临床操作中,有效提高教师的临床教学质量及学生的超声穿刺水平。

1.5T磁共振动态对比增强(DCE-MRI)技术联合表观弥散系数(ADC)值对乳腺肿块样强化病变良恶性的鉴别诊断价值

目的:分析1.5T磁共振动态对比增强(DCE-MRI)技术联合表观弥散系数(ADC)值对乳腺肿块样强化病变良恶性的鉴别诊断价值。方法:选取2021年10月至2024年4月在三明市第二医院治疗的163例乳腺肿块样强化病变患者的临床资料进行回顾性分析。选取的患者均接受1.5T DCE-MRI检查。根据强化方式、时间-信号强度(TIC)曲线、病灶形态、病灶边界,计算ADC值。以病理诊断结果为金标准,以1.5T DCE-MRI诊断结果为对照1组,以ADC诊断结果为对照2组,以联合诊断结果为观察组。对比三种诊断方式在乳腺肿块样强化病良恶性鉴别诊断中的应用价值。结果:以病理诊断结果为金标准,对比对照1组与对照2组的各项诊断效能指标,差异无统计学意义(P>0.05)。观察组的各项诊断效能指标均明显优于对照1组以及对照2组,差异具有统计学意义(P<0.05)。结论:在乳腺肿块样强化病变良恶性的鉴别诊断中,应用1.5T DCE-MRI联合ADC值具有更高的诊断效能,临床应用价值显著。

消痈汤联合手法通乳治疗哺乳期郁滞型急性乳腺炎的效果分析

目的 探讨消痈汤联合手法通乳治疗哺乳期郁滞型急性乳腺炎患者的效果。方法 前瞻性选取2023年1月至10月丽水市中医院收治的80例哺乳期郁滞型急性乳腺炎患者,按随机数字表法分为消痈汤组和联合组,每组40例。消痈汤组患者口服消痈汤治疗,联合组患者在口服消痈汤的基础上进行手法通乳。比较两组患者的临床疗效及治疗前、治疗1个疗程及治疗2个疗程后的疼痛、肿块大小、肿块数量评分及炎症因子水平;比较两组患者的脓肿、停乳及复发远期疗效。结果 消痈汤组的临床总有效率为80.00%,联合组为95.00%,联合组高于消痈汤组,差异有统计学意义(χ^(2)=4.114,P=0.043)。治疗2个疗程后,联合组患者的视觉模拟评分法评分、肿块大小及肿块数量评分低于消痈汤组,差异有统计学意义(P<0.05);联合组患者的降钙素原、C反应蛋白均低于消痈汤组,差异有统计学意义(P<0.05);联合组患者的白细胞及中性粒细胞计数均低于消痈汤组(P<0.05);联合组的复发率为5.00%低于消痈汤组的20.00%(χ^(2)=4.114,P=0.043)。结论 哺乳期郁滞型急性乳腺炎患者经消痈汤联合手法通乳治疗可显著提高近期及远期疗效,可减轻疼痛、消除肿块、抑制炎症、减少复发,值得临床推广应用。

多模态超声在乳腺非肿块型病变鉴别诊断中的应用价值探析

目的 探析多模态超声在乳腺非肿块型病变鉴别诊断中的应用价值。方法 选择2022年3月—2023年3月本院收治的94例乳腺非肿块型病变患者为研究对象,对其进行常规超声、超声血流成像、超声弹性成像检查,以病理检查结果作为金标准,分析多模态超声(三者联合)在乳腺非肿块型病变鉴别诊断中的应用价值。结果 94例乳腺非肿块型病变患者经病理检查,其中41例确诊为乳腺癌,53例确诊为良性乳腺病变。常规超声、超声血流成像、超声弹性成像及多模态超声鉴别诊断乳腺非肿块型病变与病理检查的一致性kappa值分别为0.411、0.617、0.742、0.913。多模态超声检查鉴别诊断乳腺非肿块型病变的灵敏度为95.12%(39/41)、特异度为96.23%(51/53)、准确度为95.74%(90/94)、阳性预测值为95.12%(39/41)、阴性预测值为96.23%(51/53),高于单独的常规超声、超声血流成像、超声弹性成像的鉴别诊断结果,差异显著,具有统计学意义(P<0.05)。结论 多模态超声在乳腺非肿块型病变鉴别诊断中的应用价值较高,与病理结果的一致性较高,可提升诊断准确性。

直接稀释-电感耦合等离子体质谱法测定母乳中17种元素的含量

提出了直接稀释-电感耦合等离子体质谱法(ICP-MS)同时测定母乳中钒、铬、锰、钴、镍、铜、锌、砷、硒、锶、钡、钼、镉、锡、锑、汞、铅等17种元素含量的方法。取母乳0.5 mL,用含2%(体积分数)硝酸和0.01%(体积分数)四甲基氢氧化铵的0.01%(体积分数)曲拉通X-100溶液定容至10 mL,涡旋混匀,以转速4000 r·min^(-1)离心5 min,将上清液用0.45μm水相滤膜过滤,在动能歧视(KED)模式下采用ICP-MS测定滤液中上述17种元素的含量,在线加入含6μg·L^(-1)钪、锗、铑、铋的混合内标使用液。结果表明:各元素的质量浓度在一定范围内与所对应的信号强度与内标元素信号强度比呈线性关系,检出限(3s)为0.019~0.768μg·L^(-1);方法用于分析美国国家标准参考材料,除锌元素外,其他元素的测定值均在认定值的不确定度范围内,并且日内和日间的变异系数均小于13%;按照标准加入法进行回收试验,回收率为81.3%~119%。

儿童切除乳房肿物的临床特点及预后分析

目的探讨儿童切除乳房肿物的临床特点及预后。方法回顾性收集2010年1月至2021年5月于首都医科大学附属北京儿童医院行乳房手术并经病理检查确诊为乳房肿物的34例患儿临床资料,分析女性患儿(n=28)与男性患儿(n=6)的一般情况、病理特征和影像学特点,并通过收集门诊复查资料或电话的形式随访预后。结果女性患儿就诊年龄(12.1±2.0)岁,以可触及乳房肿块(28/28,100%)和外观异常(6/28,21.4%)为主要症状,出现症状时间为3.00(0.25~60.00)个月,术前检查主要为超声检查(27/28,96.4%)和胸部CT(13/28,46.4%)。女性患儿均行乳房肿物切除术,主要入路为乳房边缘弧形切口(10/28,35.7%)和乳晕弧形切口(9/28,32.1%);切除的肿物均为良性,主要为纤维腺瘤(23/28,82.1%),术前超声检查诊断纤维腺瘤的灵敏度为90.9%(20/22)。男性患儿就诊年龄(4.5±4.2)岁,主要症状为可触及乳房肿块(6/6,100%)和外观异常(2/6,33.3%);4例良性肿瘤行乳房肿物切除术,1例分泌性乳腺癌和1例胸壁滑膜肉瘤分别行乳腺癌局部扩大切除术和胸壁肿瘤切除术。共29例(29/34,85.3%)患儿获得随访,女24例、男5例。女性患儿中,20例为纤维腺瘤,其中2例复发(2/20,10%),1例(1/20,5.0%)残留,1例(1/20,5.0%)对侧乳房出现肿物;其余4例女性乳房肿物患儿预后良好。5例男性乳房肿物患儿中,男性胸壁滑膜肉瘤术后接受放化疗,目前恢复良好;其余4例均预后良好。结论女性患儿乳房肿物以纤维腺瘤为主,超声检查能辅助术前诊断,但需警惕残留、复发;男性患儿乳房肿物的发病年龄相对较小,需考虑恶性肿瘤可能。儿童乳房肿物完整切除预后良好。

分子分型在肿块型及非肿块型乳腺癌中的差异及其与X线征像关系研究

目的 探讨肿块型及非肿块型乳腺癌的临床及分子分型差异、X线征象与分子分型的关系。方法 纳入372例乳腺X线表现为肿块型或非肿块型并经病理证实为乳腺癌的女性患者的临床、病理及影像资料,其中肿块型共210例,非肿块型共162例,回顾分析两组临床及分子分型差异及不同分子分型乳腺癌X线征象差异。结果非肿块型病灶发生于相对低龄者,非浸润性癌占比高;肿块型患者相对高龄,以浸润性癌占比更高。Luminal B型多见于肿块型,Luminal HER-2型多见于非肿块型。不同分子分型的肿块型乳腺癌的影像特征如肿块是否伴随不对称及非肿块型乳腺癌的影像特征如结构扭曲、钙化等征象发生率、钙化形态等差异有统计学意义(P均<0.05)。结论 肿块型及非肿块型乳腺癌临床、病理特征及分子分型不同,部分X线征象与肿瘤分子分型有关,对治疗方案选择、预后判断等有一定价值。

乳腺肿块良恶性诊断中乳腺超声的价值分析

目的:探讨乳腺肿块良恶性诊断中乳腺超声的价值。方法:选取2023年1月—10月宝鸡市中心医院治疗的95例乳腺肿块患者作为研究对象,均实施乳腺超声及乳腺X射线摄影,以活检或手术病理结果作为金标准,对比不同检查方式诊断结果,比较诊断效能,比较不同检查方式对不同类型乳腺疾病检出情况,分析超声良恶性肿块血流指标。结果:病理结果显示,95例乳腺肿块患者中阳性21例,阴性74例;乳腺超声诊断乳腺癌灵敏度90.48%、特异度93.24%、准确率92.63%、阳性预测值79.17%均高于乳腺X射线摄影的57.14%、81.08%、76.84%、48.15%(P<0.05);乳腺超声检查乳腺增生、乳腺囊肿、乳腺纤维腺瘤、乳腺导管内乳头状瘤、乳腺浸润性导管癌、乳腺导管原位癌、髓样癌等检出率与乳腺X射线摄影比较差异不显著(P>0.05)。恶性肿块的最大血流速度、最小血流速度、阻力指数均高于良性肿块,血流信号分级多在2~3级(P<0.05)。结论:乳腺肿块良恶性诊断中乳腺超声的价值显著,能提高对良恶性肿瘤的鉴别诊断效果,提升诊断的灵敏度、特异度、准确率。