Mehiri S, Arous Y, Salem A, Bouchlaka A, Kribi L, Sellemi M, Hamza R, Mnif N, Gueddana N
Service de radiologie, hôpital Charles Nicolle, Tunis.
Tunis Med. 2009 Jul;87(7):458-62.
This retrospective work is related to ACR3 mammograms of the program "Feasibility of breast cancer screening by mammography in Ariana Governorate" in order to evaluate the efficiency and short-term quality control of these probably benign lesions.
Mammograms classified ACR3 raised the indication of further examination, futher mammogram (profile, expanded or compression). The monitoring and control period are explained to the patient by the radiologist.
6.6% mammograms were classified as ACR 3 with 71.3% under the age of 50 years. Breast is very dense in 20.5% of cases, and transparent in 6% of cases. Further exams has been performed in 94. 5% of cases with a profile in 52% of cases, enlarged in 22.1%, compression in 24.9% and ultrasound in 82.5%. The surveillance protocol was insufficient for 126 women lost to the 1st control, 32 women lost for the 2nd control and 19 women were lost to the 3rd control. After two years monitoring, 219 women were reclassified as ACR2 with a negative test. In 2 patients, we found an invasive ductal carcinoma at 4 months control.
ACR 3 mammograms are the most important operator dependent category. The diagnosis of probably benign lesion dependant of the analysis of images and requires a great experience of the radiologist and a comprehensive complementary examination. In this study, this assessment was often heavy in relation to the frequency of dense breasts itself in connection with the young age of patients. In addition, for this particular category, the need of training is important and in terms of public health cost, the management of ACR3 mammograms increases difficulties and cost of screening.
这项回顾性研究与“阿丽亚娜省乳腺钼靶筛查乳腺癌的可行性”项目中的ACR3级乳腺钼靶检查相关，旨在评估这些可能为良性病变的检查效率和短期质量控制情况。
ACR3级的乳腺钼靶检查提示需进一步检查，即再次进行乳腺钼靶检查（侧位、放大或加压位）。放射科医生会向患者解释监测和控制期。
6.6%的乳腺钼靶检查被分类为ACR 3级，其中71.3%的患者年龄在50岁以下。20.5%的病例乳腺非常致密，6%的病例乳腺呈透亮型。94.5%的病例进行了进一步检查，其中52%为侧位检查，22.1%为放大检查，24.9%为加压检查，82.5%进行了超声检查。有126名女性在首次复查时失访，32名女性在第二次复查时失访，19名女性在第三次复查时失访，监测方案对这些患者而言并不充分。经过两年的监测，219名女性被重新分类为ACR2级且检查结果为阴性。在2名患者中，在4个月的复查时发现了浸润性导管癌。
ACR 3级乳腺钼靶检查是最依赖操作人员的类别。可能为良性病变的诊断依赖于图像分析，需要放射科医生具备丰富经验和全面的辅助检查。在本研究中，鉴于患者年龄较轻，乳腺致密的频率较高，这种评估往往较为繁重。此外，对于这一特定类别，培训需求很重要，从公共卫生成本角度来看，ACR3级乳腺钼靶检查的管理增加了筛查的难度和成本。
