Sickles E A
Department of Radiology, University of California School of Medicine, San Francisco 94143-0628.
Radiology. 1991 May;179(2):463-8. doi: 10.1148/radiology.179.2.2014293.
The author prospectively evaluated the value of periodic mammographic surveillance among 3,184 consecutive cases of nonpalpable, probably benign breast lesions detected with mammography. Follow-up consisted of four mammographic examinations during a 3- or 3.5-year period. Clinical outcome was ascertained in each case after the study period, whether or not patients complied with the protocol. Probably benign lesions were subsequently found to be malignant in 17 cases (positive predictive value for cancer, 0.5%). Fifteen of the 17 cancers were identified by means of interval mammographic change prior to development of a palpable mass; all 17 were stage 0 or stage 1 tumors. All 17 women who had cancer currently show no evidence of tumor recurrence (median duration of follow-up, 5 years). These results should help establish the validity of managing mammographically detected, probably benign lesions with periodic mammographic surveillance. By decreasing the number of biopsies of benign lesions and thereby substantially reducing costs, this approach may help overcome a major barrier to widespread use of mammographic screening.
作者前瞻性评估了在3184例经乳腺X线摄影检出的不可触及的、可能为良性的乳腺病变连续病例中进行定期乳腺X线摄影监测的价值。随访包括在3年或3.5年期间进行4次乳腺X线检查。在研究期结束后，无论患者是否遵守方案，均确定每例患者的临床结局。随后发现17例可能为良性的病变为恶性（癌症的阳性预测值为0.5%）。17例癌症中有15例是在可触及肿块出现之前通过乳腺X线检查的间期变化发现的；所有17例均为0期或1期肿瘤。目前所有17例患癌女性均无肿瘤复发迹象（中位随访时间为5年）。这些结果应有助于确立对经乳腺X线摄影检出的、可能为良性的病变进行定期乳腺X线摄影监测管理的有效性。通过减少良性病变的活检数量，从而大幅降低成本，这种方法可能有助于克服广泛应用乳腺X线筛查的一个主要障碍。
