Moss H A, Britton P D, Flower C D, Freeman A H, Lomas D J, Warren R M
Department of Radiology, Addenbrooke's Hospital Cambridge and University of Cambridge, UK.
Clin Radiol. 1999 Oct;54(10):676-82. doi: 10.1016/s0009-9260(99)91090-5.
To assess the ability of mammography and ultrasound individually and in combination to predict whether a breast abnormality is benign or malignant in patients with symptomatic breast disease.
Patients included were those in whom histological confirmation of the abnormality following surgical excision was available. Mammographic and ultrasound appearances were prospectively classified using a four-point scale (1 = no significant lesion, 2 = benign lesion, 3 = possibly malignant, 4 = probably malignant).
Histological confirmation following surgical excision was available in 559 patients, of which 303 were benign and 256 were malignant. The imaging classification was correlated with histology in these 559 lesions. In predicting final histology, the sensitivity and specificity of mammography alone were 78.9 and 82.7%, respectively, of ultrasound alone were 88.9 and 77.9%, respectively, and of mammography and ultrasound in combination were 94.2 and 67.9%, respectively. Only one patient had both a mammogram and ultrasound reported as normal (category 1 for both tests) in whom subsequent histology revealed a carcinoma (0.4% of all carcinomas).
We found that the extensive use of ultrasound increases the cancer detection rate in this selected population by 14%.
评估乳腺钼靶摄影和超声单独及联合应用对有症状乳腺疾病患者乳腺异常是良性还是恶性的预测能力。
纳入的患者为手术切除后有异常组织学确诊结果的患者。乳腺钼靶摄影和超声表现采用四点量表进行前瞻性分类（1 = 无明显病变，2 = 良性病变，3 = 可能为恶性，4 = 很可能为恶性）。
559例患者有手术切除后的组织学确诊结果，其中303例为良性，256例为恶性。这559个病变的影像学分类与组织学相关。在预测最终组织学时，单独乳腺钼靶摄影的敏感性和特异性分别为78.9%和82.7%，单独超声的敏感性和特异性分别为88.9%和77.9%，乳腺钼靶摄影和超声联合应用的敏感性和特异性分别为94.2%和67.9%。只有1例患者的乳腺钼靶摄影和超声报告均为正常（两项检查均为1类），其后续组织学检查发现为癌（占所有癌的0.4%）。
我们发现，在这一特定人群中广泛应用超声可使癌症检出率提高14%。
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