Yelland A, Graham M D, Trott P A, Ford H T, Coombes R C, Gazet J C, Polson N G
Combined Breast Clinic, St George's Hospital, London.
BMJ. 1991 Mar 16;302(6777):618-20. doi: 10.1136/bmj.302.6777.618.
To assess the individual and combined diagnostic accuracy of clinical examination, mammography, and fine needle aspiration biopsy in young women with breast cancer.
Analysis based on case notes of patients presenting with breast cancer during 1971-89.
A combined breast clinic.
Consecutive series of 81 women aged less than 36 with histologically proved breast cancer presenting with a discrete mass over 19 years.
Results of clinical examination, xeromammography or conventional mammography, fine needle aspiration biopsy, and examination of tissue removed by surgery.
The clinical diagnosis was correct in 47 women and radiography in 35. Fine needle aspiration biopsy was correct in 47 of the 63 women in whom it was successfully performed. Fine needle aspiration was significantly more accurate than mammography (78% v 45%, p less than 0.01). Ten (16%) patients had negative results on clinical examination, mammography, and fine needle aspiration.
Mammography alone seems inadequately sensitive to detect breast cancer in young patients. When all investigations give negative results excision biopsy is the only way of obtaining a definitive diagnosis.
评估临床检查、乳房X线摄影及细针穿刺活检对年轻乳腺癌女性患者的单独及联合诊断准确性。
基于1971 - 1989年间乳腺癌患者病历的分析。
一家联合乳腺诊所。
连续纳入81例年龄小于36岁、经组织学证实患有乳腺癌且有单个肿块的女性患者，研究时间跨度为19年。
临床检查、干板乳房X线摄影或传统乳房X线摄影、细针穿刺活检以及手术切除组织检查的结果。
47例女性患者临床诊断正确，35例放射学诊断正确。在63例成功进行细针穿刺活检的女性患者中，47例诊断正确。细针穿刺活检的准确性显著高于乳房X线摄影（78%对45%，p<0.01）。10例（16%）患者临床检查、乳房X线摄影及细针穿刺活检结果均为阴性。
单独使用乳房X线摄影对年轻患者乳腺癌的检测似乎敏感性不足。当所有检查结果均为阴性时，切除活检是获得明确诊断的唯一方法。
