Bolton Breast Unit, Royal Bolton Hospital, Bolton, UK.
Clin Radiol. 2010 Mar;65(3):218-22. doi: 10.1016/j.crad.2009.11.009. Epub 2010 Jan 4.
To establish clinical and ultrasonic criteria by which needle sampling can be safely avoided in young women with solid breast masses.
The databases of a large hospital were searched for breast cancers, phyllodes tumours, and papillomas diagnosed in women below the age of 30 years. In addition, the clinical and sonographic findings in female patients less than 25 years of age presenting with a solid breast mass over a 1-year period were reviewed.
Nine women with breast cancer, seven with phyllodes, and six with papillomas were found. No delayed diagnoses in those who had ultrasound would have been made if the following criteria had been applied to avoid needle sampling: age less than 25 years; no known risk factors for breast malignancy; mass not rapidly enlarging; smooth discrete mobile mass on clinical examination, or lesion impalpable; well-defined homogeneously isoechoic or mildly hypoechoic solid mass; less than 3 cm in greatest dimension; ovoid shape, aligned parallel to the skin surface; smooth or gently lobulated contour (two or three lobulations only; no microlobulation); thin echogenic pseudocapsule; no calcification; no acoustic shadowing. Needle sampling could have been safely avoided in approximately two-thirds of the women reviewed below the age of 25 with a solid breast mass.
Application of the proposed criteria would spare a significant number of young women unnecessary needle sampling.
建立临床和超声标准，以便在年轻女性的实性乳腺肿块中安全避免进行针吸活检。
在一家大医院的数据库中搜索了 30 岁以下女性诊断为乳腺癌、叶状肿瘤和乳头状瘤的病例。此外，还回顾了在过去一年中，年龄小于 25 岁且出现实性乳腺肿块的女性患者的临床和超声检查结果。
发现 9 例乳腺癌、7 例叶状肿瘤和 6 例乳头状瘤患者。如果应用以下标准来避免进行针吸活检，则在那些进行了超声检查的患者中不会出现延迟诊断：年龄小于 25 岁；无已知的乳腺癌发生风险因素；肿块没有快速增大；临床检查时为光滑离散可移动的肿块，或触诊时无肿块；界限清楚的均匀等回声或轻度低回声实性肿块；最大直径小于 3 厘米；卵圆形，与皮肤表面平行排列；光滑或轻微分叶状轮廓（仅 2 或 3 个叶）；无微小分叶；薄的高回声假包膜；无钙化；无声影。对于年龄小于 25 岁且出现实性乳腺肿块的女性，应用提出的标准可以安全避免对大约三分之二的女性进行针吸活检。
应用该标准可以避免对许多年轻女性进行不必要的针吸活检。
