Berg W A, Gilbreath P L
Department of Radiology, Greenebaum Cancer Center, University of Maryland, Baltimore 21201, USA.
Radiology. 2000 Jan;214(1):59-66. doi: 10.1148/radiology.214.1.r00ja2559.
To evaluate preoperative whole-breast ultrasonography (US) in the management of breast cancer.
The ipsilateral breast in 40 patients with known breast cancer or in whom there was high suspicion of breast cancer was evaluated with whole-breast US. Biopsy was performed on all discrete solid lesions.
US depicted 45 (94%) of 48 invasive tumor foci and seven (44%) of 16 foci of ductal carcinoma in situ (DCIS). Mammography depicted 39 (81%) of 48 invasive tumor foci and 14 (88%) of 16 foci of DCIS. The nine (14%) of 64 malignant foci seen only at US included three infiltrating ductal carcinomas, two mixed infiltrating and intraductal carcinomas, two infiltrating lobular carcinomas, and two foci of DCIS. Two (18%) of 11 foci of infiltrating lobular carcinoma were missed at both US and mammography. Of 20 patients mammographically suspected of having unifocal disease, three (15%) required wider excision on the basis of US findings. Two additional foci were depicted only at US in one of 16 patients mammographically suspected of having multicentric or multifocal disease. Of four patients with mammographically occult disease, US correctly depicted the diffuse (n = 2) or unifocal (n = 2) extent of the cancer.
Whole-breast US complements mammography in the preoperative evaluation of patients with breast cancer, particularly when breast conservation is contemplated.
评估术前全乳超声检查（US）在乳腺癌管理中的应用。
对40例已知患有乳腺癌或高度怀疑患有乳腺癌的患者的同侧乳房进行全乳超声检查。对所有离散实性病变进行活检。
超声检查显示48个浸润性肿瘤病灶中的45个（94%）以及16个导管原位癌（DCIS）病灶中的7个（44%）。乳腺X线摄影显示48个浸润性肿瘤病灶中的39个（81%）以及16个DCIS病灶中的14个（88%）。仅在超声检查中发现的64个恶性病灶中的9个（14%）包括3个浸润性导管癌、2个浸润性和导管内混合癌、2个浸润性小叶癌以及2个DCIS病灶。11个浸润性小叶癌病灶中有2个（18%）在超声检查和乳腺X线摄影中均未被发现。在乳腺X线摄影怀疑为单发病灶的20例患者中，3例（15%）根据超声检查结果需要进行更广泛的切除。在乳腺X线摄影怀疑为多中心或多灶性疾病的16例患者中的1例中，仅在超声检查中发现了另外2个病灶。在4例乳腺X线摄影隐匿性疾病患者中，超声检查正确显示了癌症的弥漫性（n = 2）或单发性（n = 2）范围。
全乳超声检查在乳腺癌患者的术前评估中补充了乳腺X线摄影，特别是在考虑保乳治疗时。
