Breast cancer is the most common malignant tumor in Chinese women,and its incidence is increasing.Regular screening is an effective method for early tumor detection and improving patient prognosis.In this review,we an...Breast cancer is the most common malignant tumor in Chinese women,and its incidence is increasing.Regular screening is an effective method for early tumor detection and improving patient prognosis.In this review,we analyze the epidemiological changes and risk factors associated with breast cancer in China and describe the establishment of a screening strategy suitable for Chinese women.Chinese patients with breast cancer tend to be younger than Western patients and to have denser breasts.Therefore,the age of initial screening in Chinese women should be earlier,and the importance of screening with a combination of ultrasound and mammography is stressed.Moreover,Chinese patients with breast cancers have several ancestry-specific genetic features,and aiding in the determination of genetic screening strategies for identifying high-risk populations.On the basis of current studies,we summarize the development of risk-stratified breast cancer screening guidelines for Chinese women and describe the significant improvement in the prognosis of patients with breast cancer in China.展开更多
Aim of the study: To perform Dynamic contrast enhanced MRI of breast in patients with positive findings (BIRADS 3, 4 and 5) detected on screening mammography;to correlate the findings of digital mammography and contra...Aim of the study: To perform Dynamic contrast enhanced MRI of breast in patients with positive findings (BIRADS 3, 4 and 5) detected on screening mammography;to correlate the findings of digital mammography and contrast enhanced MRI of breast with histopathological examinations. Settings and Design: A prospective observation study was conducted at a single centre, i.e. HCG Manavata Cancer Centre. Materials and Methods: Screening mammography was performed on patients with age > 40 years and on patients with age 35 - 40 years having positive family history. The positive mammography was reported and the lesions classified according to BIRADS criteria for mammography. Results: Mammographic examination of the breast lesions yielded an overall sensitivity of 97.67% and a specificity of 85.71%. In our study we combined both morphologic and dynamic parameters and its modification into BIRADS category for lesion classification. The sensitivity of MRI examinations was 97.67% while the specificity was 71.43%. Spiculated margins were encountered only in malignant lesions (p = 0.0006). Statistical correlation was obtained between the pathologically proven benign and malignant lesions regarding their enhancement pattern with p value of Conclusion: As per the results, dynamic contrast MRI had high sensitivity but limited specificity. We did not find any significant difference between FFDM and MRI in terms of diagnostic accuracy. The use of DWI showed high specificity at cut off point of ADC value—0.85 mm2/s. Thus, DWI can be used in addition of morphological and dynamic kinetic characteristics to increase specificity of MRI.展开更多
乳腺癌是女性最常见的恶性肿瘤,且发病率逐年增高,严重威胁女性生命健康,早诊断、早治疗对于提高乳腺癌患者的生存质量至关重要。常规的多序列乳腺MRI检查费用昂贵且扫描时间、图像后处理及医师阅片时间较长,限制了乳腺MRI在临床上的广...乳腺癌是女性最常见的恶性肿瘤,且发病率逐年增高,严重威胁女性生命健康,早诊断、早治疗对于提高乳腺癌患者的生存质量至关重要。常规的多序列乳腺MRI检查费用昂贵且扫描时间、图像后处理及医师阅片时间较长,限制了乳腺MRI在临床上的广泛应用。简化乳腺MRI(abbreviated breast MRI,AB-MRI)有望解决临床实际问题。AB-MRI方案更容易被患者接受,作为一种乳腺癌筛查方法前景可期。目前,术前应用AB-MRI评估乳腺癌疾病程度、新辅助化疗反应评估等方面的研究尚显不足,仍需要进行更大规模的前瞻性研究。本文从AB-MRI概念的提出、序列设计及临床应用等方面进行综述,包括不同风险人群乳腺癌的筛查、乳腺良恶性肿瘤鉴别、乳腺癌术前分期以及对新辅助化疗反应评估等多方面的临床应用,以帮助影像医师加强对AB-MRI方案的理解与应用,有助于提升我国乳腺癌的精准诊疗水平。展开更多
目的探讨DW-MRI(diffusion-weighted magnetic resonance imaging,DW-MRI)作为乳腺X线摄影(mammography,MMG)筛查乳腺癌的补充方式在致密性乳腺中的诊断效能,并对比分析与动态增强磁共振成像(dynamic contrast-enhanced magnetic resona...目的探讨DW-MRI(diffusion-weighted magnetic resonance imaging,DW-MRI)作为乳腺X线摄影(mammography,MMG)筛查乳腺癌的补充方式在致密性乳腺中的诊断效能,并对比分析与动态增强磁共振成像(dynamic contrast-enhanced magnetic resonance imaging,DCE-MRI)诊断价值的差异。方法回顾性分析病理确诊的82例乳腺癌患者及41例健康或病理证实为良性病变的阴性病例作为模拟筛查人群,分析其MMG及DWI、MMG/DWI、DCE-MRI影像学资料,比较4种检查技术对乳腺疾病诊断的敏感性和特异性。结果MMG、DWI、MMG/DWI及DCE-MRI诊断的敏感性分别为52.44%、76.83%、85.37%、93.90%;特异性分别为51.22%、65.85%、78.05%、85.36%。MMG与DWI联合检查的敏感性及特异性显著高于MMG单独检查(P<0.01),但仍低于DCE-MRI(P>0.05)。MMG/DWI的受试者工作特性(receiver operating characteristic,ROC)曲线下面积(AUC)(AUC 0.817)虽然低于DCE-MRI(AUC 0.896),但与单独的MMG(AUC 0.518)相比,MMG和DWI-MRI的组合具有更高的敏感度(85.37%)。结论在乳腺组织致密的女性中,DWI和MMG相结合可明显提高诊断的敏感性和特异性。DW-MRI可作为一种快速辅助筛查乳腺癌的工具。展开更多
目的探讨全数字化乳腺X线摄影（full field digital mammography,FFDM）及彩色多普勒血流成像（color Doppler flow imaging,CDFI）对乳腺癌的诊断价值,并分析FFDM及CDFI特征与乳腺良/恶性病变的关系,为提高乳腺癌患者的早期诊断准确率...目的探讨全数字化乳腺X线摄影（full field digital mammography,FFDM）及彩色多普勒血流成像（color Doppler flow imaging,CDFI）对乳腺癌的诊断价值,并分析FFDM及CDFI特征与乳腺良/恶性病变的关系,为提高乳腺癌患者的早期诊断准确率提供依据。方法选取2010年1月至2014年7月本院经手术病理证实且于术前行FFDM及CDFI检查的435例乳腺癌患者和239例乳腺良性肿瘤患者为研究对象。以病理检查结果作为金标准,分别计算FFDM、CDFI及其联合应用对乳腺癌诊断的灵敏度、特异度、正确指数、阳性预测值和阴性预测值,并比较三种方法的诊断结果,进一步分析FFDM及CDFI特征与乳腺良/恶性病变的关系。结果 FFDM对乳腺癌诊断的灵敏度、特异度及正确指数均高于CDFI,FFDM＋CDFI诊断的灵敏度、特异度及正确指数均高于单独诊断。FFDM、CDFI、病理检查结果均一致的患者,乳腺良/恶性病变的FFDM及CDFI特征分析显示,乳腺癌患者的肿块形态不规则、边缘呈毛刺及浸润、结构扭曲及钙化的比例均高于乳腺良性肿瘤（P〈0.05）;乳腺癌患者的肿块形态不规则、边缘呈毛刺、浸润及小分叶、回声不均匀、钙化、血流信号2-4级的比例均高于乳腺良性肿瘤（P〈0.05）。结论 FFDM在乳腺癌的诊断中具有较高的应用价值,FFDM与CDFI联合检查对乳腺癌及不同临床分期乳腺癌的诊断均优于单独诊断。乳腺病变中FFDM及CDFI特征对乳腺良/恶性病变的鉴别诊断有一定意义。展开更多
基金This work was supported by Grants from the National Key R&D Project of China(Grant No.2020YFA0112304)the National Natural Science Foundation of China(Grant Nos.91959207,92159301 and 82002792)+3 种基金the Shanghai Key Laboratory of Breast Cancer(Grant No.12DZ2260100)the Shanghai Key Clinical Specialty of Oncology(Grant No.shslczdzk02001)the Clinical Research Plan of SHDC(Grant Nos.SHDC2020CR4002 and SHDC2020CR5005)the Shanghai Sailing Program(Grant No.20YF1408600).
文摘Breast cancer is the most common malignant tumor in Chinese women,and its incidence is increasing.Regular screening is an effective method for early tumor detection and improving patient prognosis.In this review,we analyze the epidemiological changes and risk factors associated with breast cancer in China and describe the establishment of a screening strategy suitable for Chinese women.Chinese patients with breast cancer tend to be younger than Western patients and to have denser breasts.Therefore,the age of initial screening in Chinese women should be earlier,and the importance of screening with a combination of ultrasound and mammography is stressed.Moreover,Chinese patients with breast cancers have several ancestry-specific genetic features,and aiding in the determination of genetic screening strategies for identifying high-risk populations.On the basis of current studies,we summarize the development of risk-stratified breast cancer screening guidelines for Chinese women and describe the significant improvement in the prognosis of patients with breast cancer in China.
文摘Aim of the study: To perform Dynamic contrast enhanced MRI of breast in patients with positive findings (BIRADS 3, 4 and 5) detected on screening mammography;to correlate the findings of digital mammography and contrast enhanced MRI of breast with histopathological examinations. Settings and Design: A prospective observation study was conducted at a single centre, i.e. HCG Manavata Cancer Centre. Materials and Methods: Screening mammography was performed on patients with age > 40 years and on patients with age 35 - 40 years having positive family history. The positive mammography was reported and the lesions classified according to BIRADS criteria for mammography. Results: Mammographic examination of the breast lesions yielded an overall sensitivity of 97.67% and a specificity of 85.71%. In our study we combined both morphologic and dynamic parameters and its modification into BIRADS category for lesion classification. The sensitivity of MRI examinations was 97.67% while the specificity was 71.43%. Spiculated margins were encountered only in malignant lesions (p = 0.0006). Statistical correlation was obtained between the pathologically proven benign and malignant lesions regarding their enhancement pattern with p value of Conclusion: As per the results, dynamic contrast MRI had high sensitivity but limited specificity. We did not find any significant difference between FFDM and MRI in terms of diagnostic accuracy. The use of DWI showed high specificity at cut off point of ADC value—0.85 mm2/s. Thus, DWI can be used in addition of morphological and dynamic kinetic characteristics to increase specificity of MRI.
文摘乳腺癌是女性最常见的恶性肿瘤,且发病率逐年增高,严重威胁女性生命健康,早诊断、早治疗对于提高乳腺癌患者的生存质量至关重要。常规的多序列乳腺MRI检查费用昂贵且扫描时间、图像后处理及医师阅片时间较长,限制了乳腺MRI在临床上的广泛应用。简化乳腺MRI(abbreviated breast MRI,AB-MRI)有望解决临床实际问题。AB-MRI方案更容易被患者接受,作为一种乳腺癌筛查方法前景可期。目前,术前应用AB-MRI评估乳腺癌疾病程度、新辅助化疗反应评估等方面的研究尚显不足,仍需要进行更大规模的前瞻性研究。本文从AB-MRI概念的提出、序列设计及临床应用等方面进行综述,包括不同风险人群乳腺癌的筛查、乳腺良恶性肿瘤鉴别、乳腺癌术前分期以及对新辅助化疗反应评估等多方面的临床应用,以帮助影像医师加强对AB-MRI方案的理解与应用,有助于提升我国乳腺癌的精准诊疗水平。
文摘目的探讨全数字化乳腺X线摄影（full field digital mammography,FFDM）及彩色多普勒血流成像（color Doppler flow imaging,CDFI）对乳腺癌的诊断价值,并分析FFDM及CDFI特征与乳腺良/恶性病变的关系,为提高乳腺癌患者的早期诊断准确率提供依据。方法选取2010年1月至2014年7月本院经手术病理证实且于术前行FFDM及CDFI检查的435例乳腺癌患者和239例乳腺良性肿瘤患者为研究对象。以病理检查结果作为金标准,分别计算FFDM、CDFI及其联合应用对乳腺癌诊断的灵敏度、特异度、正确指数、阳性预测值和阴性预测值,并比较三种方法的诊断结果,进一步分析FFDM及CDFI特征与乳腺良/恶性病变的关系。结果 FFDM对乳腺癌诊断的灵敏度、特异度及正确指数均高于CDFI,FFDM＋CDFI诊断的灵敏度、特异度及正确指数均高于单独诊断。FFDM、CDFI、病理检查结果均一致的患者,乳腺良/恶性病变的FFDM及CDFI特征分析显示,乳腺癌患者的肿块形态不规则、边缘呈毛刺及浸润、结构扭曲及钙化的比例均高于乳腺良性肿瘤（P〈0.05）;乳腺癌患者的肿块形态不规则、边缘呈毛刺、浸润及小分叶、回声不均匀、钙化、血流信号2-4级的比例均高于乳腺良性肿瘤（P〈0.05）。结论 FFDM在乳腺癌的诊断中具有较高的应用价值,FFDM与CDFI联合检查对乳腺癌及不同临床分期乳腺癌的诊断均优于单独诊断。乳腺病变中FFDM及CDFI特征对乳腺良/恶性病变的鉴别诊断有一定意义。
