Burrell H C, Evans A J, Wilson A R, Pinder S E
Nottingham Breast Screening Unit, City Hospital NHS Trust, Nottingham NG5 1PG, U.K.
Clin Radiol. 2001 May;56(5):385-8. doi: 10.1053/crad.2001.0662.
To review women who have had breast cancer diagnosed following previous assessment of a screen-detected mammographic abnormality in order to ascertain the frequency and characteristics of false-negative assessment.
The assessment process was reviewed in the study population of 28 women. This included the nature of the lesion recalled for assessment, additional mammography, clinical and ultrasound findings, and the results of fine needle aspiration cytology and needle histology.
The frequency of false-negative assessment was approximately 0.56%. The median time between false-negative assessment and diagnosis of breast cancer was 33 months. The most common mammographic lesion resulting in false-negative assessment was micro-calcification seen in 12 cases (43%). Only five of these 12 cases had image-guided biopsy, the remainder were thought to be benign on magnification views. Other mammographic abnormalities were nine masses (32%), five architectural distortions (18%) and two asymmetric densities (7%). Of the 16 women with mammographic lesions other than micro-calcifications 10 had a normal ultrasound.
Radiological interpretation of indeterminate micro-calcifications as benign or malignant is unreliable. An isolated cluster of micro-calcification requires image-guided core biopsy with representative micro-calcification obtained on specimen radiography. Further mammography done at assessment, particularly paddle compression views, should be carefully analysed to ensure areas of architectural distortion have truly resolved. If one imaging modality shows a significant abnormality and another does not the cases must be managed on the basis of the abnormal finding. Burrell, H.C.et al. (2001). Clinical Radiology56, 385-388.
回顾那些在先前对筛查发现的乳腺钼靶异常进行评估后被诊断为乳腺癌的女性患者，以确定假阴性评估的频率和特征。
对28名女性的研究人群的评估过程进行了回顾。这包括被召回进行评估的病变性质、额外的乳腺钼靶检查、临床和超声检查结果，以及细针穿刺细胞学检查和针吸活检组织学检查结果。
假阴性评估的频率约为0.56%。假阴性评估与乳腺癌诊断之间的中位时间为33个月。导致假阴性评估的最常见乳腺钼靶病变是微钙化，见于12例（43%）。这12例中只有5例进行了影像引导下活检，其余在放大视图下被认为是良性的。其他乳腺钼靶异常包括9个肿块（32%）、5个结构扭曲（18%）和2个不对称密度影（7%）。在16例有除微钙化以外的乳腺钼靶病变的女性中，10例超声检查正常。
将不确定的微钙化在影像学上解释为良性或恶性是不可靠的。孤立的微钙化簇需要进行影像引导下的核心活检，并在标本射线摄影上获得具有代表性的微钙化。在评估时进行的进一步乳腺钼靶检查，尤其是压迫板视图，应仔细分析，以确保结构扭曲区域确实已消失。如果一种成像方式显示有明显异常而另一种没有，则必须根据异常发现来处理病例。伯勒尔，H.C.等人（2001年）。《临床放射学》56卷，第385 - 388页。
