Kald B A, Boiesen P, Ronnow K, Jonsson P E, Bisgaard T
Departments of Surgery, Helsingborg Hospital, Helsingborg, Sweden.
Scand J Surg. 2005;94(1):15-20. doi: 10.1177/145749690509400105.
In patients with breast cancer, planning of the surgical strategy may rely on preoperative tumour size. The optimal method for assessment of small tumours has not been established. We compared findings from preoperative mammography and ultrasonography with histopathological tumour size in patients treated with breast-conserving surgery.
The study was retrospective and the setting a single institution clinic with free referral of patients. The patients were examined before the operation with mammography, ultrasonography, and findings were compared with postoperative histopathological tumour size.
The study included 131 patients (median age was 59) years with grade I, II, and III cancers in 47, 71 and in 13 patients, respectively. The medium histological tumour size was 14 mm, range 4-45 mm. A wide 95% confidence interval between histopathological tumour size and preoperative mammography (standard deviation 4.8 mm) and ultrasonography (standard deviation 4.8 mm) was found. The combination of mammography and ultrasonography did not improve the results (standard deviation 4.3 mm). Preoperative mammography tended to over estimate the tumour size compared with histological tumour size whereas preoperative ultrasonography tended to underestimate the tumour size.
In this retrospective study with preoperative evaluation of small breast cancers by mammography and ultrasonography, wide 95% confidence intervals for the methods were found and they should therefore be used with caution in the planning of the surgical strategy.
对于乳腺癌患者，手术策略的制定可能依赖于术前肿瘤大小。评估小肿瘤的最佳方法尚未确立。我们比较了保乳手术患者术前乳腺X线摄影和超声检查结果与组织病理学肿瘤大小。
本研究为回顾性研究，研究地点为一家接受患者免费转诊的单机构诊所。患者在手术前接受乳腺X线摄影、超声检查，并将检查结果与术后组织病理学肿瘤大小进行比较。
该研究纳入了131例患者（中位年龄59岁），其中I级、II级和III级癌症患者分别为47例、71例和13例。组织学肿瘤大小中位数为14mm，范围为4 - 45mm。发现组织病理学肿瘤大小与术前乳腺X线摄影（标准差4.8mm）和超声检查（标准差4.8mm）之间的95%置信区间较宽。乳腺X线摄影和超声检查联合使用并未改善结果（标准差4.3mm）。与组织学肿瘤大小相比，术前乳腺X线摄影倾向于高估肿瘤大小，而术前超声检查倾向于低估肿瘤大小。
在这项通过乳腺X线摄影和超声检查对小乳腺癌进行术前评估的回顾性研究中，发现这两种方法的95%置信区间较宽，因此在制定手术策略时应谨慎使用。
