Symonds D A, Copeland B E, Drane A, Kaplan G N, Graham R R
Department of Laboratory Medicine, Union Memorial Hospital, Baltimore, MD 21218.
Arch Pathol Lab Med. 1992 Jan;116(1):28-32.
In a series of 1137 diagnostic breast biopsy specimens in a 2-year period, nearly half (n = 534) underwent specimen mammography. Calcifications were found in 48% of the specimen mammograms. In a quarter of the cases, calcification was a marker either for carcinoma or a significant precursor lesion. Moreover, in the majority of these malignancies, calcifications were markers of preinvasive carcinoma. In another quarter of cases, some form of proliferative ductal hyperplasia accounted for calcifications, and in the remainder, cysts and miscellaneous other conditions accounted for calcifications. The yield of malignancy was much lower in noncalcified specimens (12%). A nodular or asymmetric density proved to be a fibroadenoma in 30% of cases. However, the majority of cases had less well-defined changes, probably representing some form of lobular fibrosis. We found submission of a duplicate specimen mammogram with the breast biopsy specimen to pathology to be a significant adjunct to correlation. The abnormal area is marked on the mammogram by the radiologist for the pathologist. This is particularly helpful for localizing noncalcified stromal abnormalities. Calcifications are most easily and reliably isolated by serial slicing and performing another radiograph of the slices.
在两年期间的1137份乳腺诊断活检标本系列中，近一半（n = 534）进行了标本乳腺X线摄影。在48%的标本乳腺X线片中发现了钙化。在四分之一的病例中，钙化是癌或重要前驱病变的标志物。此外，在这些恶性肿瘤的大多数病例中，钙化是浸润前癌的标志物。在另外四分之一的病例中，某种形式的增生性导管增生导致了钙化，其余病例中，囊肿和其他各种情况导致了钙化。非钙化标本中的恶性肿瘤检出率要低得多（12%）。在30%的病例中，结节状或不对称密度被证实为纤维腺瘤。然而，大多数病例的变化不太明确，可能代表某种形式的小叶纤维化。我们发现，将乳腺活检标本的重复标本乳腺X线片提交给病理科是一种重要的辅助关联手段。放射科医生在乳腺X线片上为病理科医生标记出异常区域。这对于定位非钙化性间质异常特别有帮助。通过连续切片并对切片进行另一次X线摄影，钙化最容易且可靠地被分离出来。
