Tran D Q, Wilkerson D K, Namm J, Zeis M A, Cottone F J
Department of Surgery, St. Francis Medical Center, Trenton, New Jersey 08629, USA.
Am Surg. 1999 Mar;65(3):283-8.
Increased awareness of benefits of early detection of breast cancer has resulted in increased numbers of screening mammographies and breast biopsies for nonpalpable lesions. Tertiary hospital studies have demonstrated positive biopsy rates from abnormal mammographic findings at 18 to 32 per cent. We examined the effectiveness of needle biopsy for nonpalpable radiographic abnormalities in our community hospital. We reviewed 167 records of patients biopsied over a 2-year period. Mammographic assessment, biopsy, and pathological assessment were performed using accepted methods. Malignancy was detected in 34 of 167 biopsies (20%). The biopsy yield rate was highest for mammographic findings of spiculated or stellate masses (75%, P < 0.01). Most biopsies (83%) were performed because of mammographic findings of microcalcifications or circumscribed enlarging masses/nodular developing densities for a positive biopsy yield rate of 16 per cent. Rates were higher in patients with personal (44%) or family history (30%) of breast cancer and in postmenopausal women (30%). These results demonstrate that 1) factors such as age, personal or family history of breast cancer, and certain mammographic features of breast lesions are associated with high biopsy yield rates, and 2) the biopsy yield rate in our community setting is comparable to tertiary hospital experience.
对乳腺癌早期检测益处的认识提高，导致针对不可触及病变的乳腺钼靶筛查和乳腺活检数量增加。三级医院研究表明，乳腺钼靶异常发现的活检阳性率为18%至32%。我们在社区医院研究了针吸活检对不可触及的影像学异常的有效性。我们回顾了2年期间167例接受活检患者的记录。采用公认方法进行乳腺钼靶评估、活检和病理评估。167例活检中有34例（20%）检测到恶性肿瘤。乳腺钼靶显示毛刺状或星状肿块时活检阳性率最高（75%，P<0.01）。大多数活检（83%）是因为乳腺钼靶发现微钙化或边界清晰的增大肿块/结节状密度增高，活检阳性率为16%。有乳腺癌个人史（44%）或家族史（30%）的患者以及绝经后女性（30%）的活检阳性率更高。这些结果表明，1）年龄、乳腺癌个人或家族史以及乳腺病变的某些钼靶特征等因素与高活检阳性率相关，2）我们社区环境中的活检阳性率与三级医院的经验相当。
