Muttarak M, Pojchamarnwiputh S, Padungchaichote W, Chaiwun B
Department of Radiology, Chiang Mai University, Thailand.
Singapore Med J. 2002 May;43(5):229-33.
To assess the value of mammography in the detection of cancer in the contralateral breast in women with ipsilateral breast carcinoma.
From February 1994 through May 2001, a total of 500 patients with unilateral mastectomy from breast carcinoma had mammograms performed for the first time following mastectomy. We retrospectively reviewed the clinical findings and mammograms of these patients. Four hundred and sixty-four patients were asymptomatic and 36 patients presented with palpable breast or axillary masses. Specific mammographic features of a mass, microcalcifications, architectural distortion and asymmetric density were evaluated. Diagnosis was confirmed by fine needle aspiration biopsy or surgical excision in all patients.
Four hundred and sixty-four patients had screening mammograms and 36 patients had diagnostic mammograms. All 36 symptomatic patients had abnormal mammograms. Of these, 12 (33.33%) patients were found to have second primary breast carcinoma, 12 (33.33%) had metastases to the contralateral breast or axillary lymph nodes, six (16.66%) had fibroadenomas, two (5.55%) had abscesses, three (8.33%) had fibrocystic change, and one (2.77%) had axillary node reactive hyperplasia. Of the 464 asymptomatic patients, five (1.07%) had second primary breast carcinoma, five (1.07%) had fibrocystic change, and two (0.43%) had fibroadenomas. The mean age at the time of diagnosis of the first primary carcinoma in the symptomatic patients was 41.9 years (range 35-60 years), and was 43.4 years (range 36-56 years) in the screening group. The mean time interval between the two carcinomas was four years (range one to 13 years) in symptomatic group and 3.4 years (range one to four years) in screening group. The tumour stage in the screened group was in situ (n = 2), stage I (n = 3) and in the symptomatic group was stage I (n = 2), stage II (n = 5), stage III (n = 5).
Patients who have ipsilateral breast carcinoma have a strong risk to develop a second primary carcinoma in the contralateral breast. Close follow-up of the second breast with careful clinical examination and mammography are necessary for the early detection of cancer.
评估乳腺钼靶摄影在同侧乳腺癌女性对侧乳房癌症检测中的价值。
从1994年2月至2001年5月，共有500例单侧乳腺癌乳房切除术患者在乳房切除术后首次进行了钼靶摄影。我们回顾性分析了这些患者的临床资料和钼靶摄影结果。464例患者无症状，36例患者可触及乳房或腋窝肿块。对肿块、微钙化、结构扭曲和不对称密度等特定的钼靶摄影特征进行了评估。所有患者均通过细针穿刺活检或手术切除确诊。
464例患者进行了筛查性钼靶摄影，36例患者进行了诊断性钼靶摄影。所有36例有症状的患者钼靶摄影均异常。其中，12例（33.33%）患者被发现患有第二原发性乳腺癌，12例（33.33%）有对侧乳房或腋窝淋巴结转移，6例（16.66%）有纤维腺瘤，2例（5.55%）有脓肿，3例（8.33%）有纤维囊性变，1例（2.77%）有腋窝淋巴结反应性增生。在464例无症状患者中，5例（1.07%）患有第二原发性乳腺癌，5例（1.07%）有纤维囊性变，2例（0.43%）有纤维腺瘤。有症状患者中首次原发性癌诊断时的平均年龄为41.9岁（范围35 - 60岁），筛查组为43.4岁（范围36 - 56岁）。有症状组中两种癌症之间的平均时间间隔为4年（范围1至13年），筛查组为3.4年（范围1至4年）。筛查组的肿瘤分期为原位癌（n = 2）、I期（n = 3），有症状组为I期（n = 2）、II期（n = 5）、III期（n = 5）。
患有同侧乳腺癌的患者发生对侧乳房第二原发性癌的风险很高。对另一侧乳房进行密切随访，仔细的临床检查和钼靶摄影对于早期发现癌症是必要的。
