用于评估非离散性肿块性乳房中乳腺结节的视觉模拟量表：勒克瑙-卡迪夫乳腺结节量表。
Visual analogue scale for assessing breast nodularity in non-discrete lumpy breasts: the Lucknow-Cardiff breast nodularity scale.
机构信息
Department of Surgery, King George's Medical University, Lucknow, UP, India.
出版信息
Breast. 2010 Jun;19(3):238-42. doi: 10.1016/j.breast.2010.02.002. Epub 2010 Mar 11.
BACKGROUND
Objective measurement of benign non-discrete lumpy breasts is not performed routinely that would lead to disease measurement, inter-physician communication, therapeutic response assessment and a normative function of reducing unnecessary biopsies. A schematic 5-point ordinal visual analogue scale was developed.
METHODS
Two blinded experienced clinicians graded breast nodularity on a pre-determined five point analogue scale (grades 0-4) to determine its inter-observer reliability after its face validity that excluded inflammatory, nipple, areola and discrete lump problems.
RESULTS
784 Women (hospital 384; community 400) aged between 20 and 70 years (mean 31.9) underwent physical breast examination by 2 experienced clinicians. Inter-observer matched nodularity grading in women attending hospital were Grade 0 in 123 (32.03%), grade 1 in 67 (17.44%), grade 2 in 54 (14.06%), grade 3 in 52 (13.54%) and grade 4 in 23 (5.99%) and in community it was grade 0 in 172 (43%), grade 1 in 88 (22%), grade 2 in 60 (15%), grade 3 in 28 (7%) and grade 4 in 14 (3.5%) women. There was very good agreement (kappa = 0.7798) across all grades in hospital subjects and excellent agreement (kappa = 0.8659) in community subjects. Both estimates of kappa coefficients were highly significant from population kappa coefficient of zero (p < 0.001). Overall, 1/3rd normal women have absolutely smooth textured breasts.
CONCLUSION
User-friendly tool developed for objective evaluation of non-discrete lumpy breasts showed excellent reliability and validity. This tool should be useful for clinical drug trials in benign breast disorders and for wide routine clinical recording of patients.
背景
良性非离散性肿块性乳房的客观测量并未常规进行，这将导致疾病测量、医生间的沟通、治疗反应评估以及减少不必要活检的规范功能。为此，我们开发了一种直观的 5 分序贯视觉模拟量表。
方法
两位经验丰富的临床医生对预先确定的 5 分模拟量表（0-4 级）上的乳房结节进行分级，以确定其在排除炎症、乳头、乳晕和离散性肿块问题后的观察者间可靠性。
结果
784 名年龄在 20 至 70 岁之间（平均年龄 31.9 岁）的女性接受了 2 位经验丰富的临床医生进行的体格乳房检查。在医院就诊的女性中，观察者间匹配的结节分级为 0 级 123 例（32.03%），1 级 67 例（17.44%），2 级 54 例（14.06%），3 级 52 例（13.54%），4 级 23 例（5.99%）；而在社区就诊的女性中，0 级 172 例（43%），1 级 88 例（22%），2 级 60 例（15%），3 级 28 例（7%），4 级 14 例（3.5%）。在医院就诊的所有分级中，一致性均非常好（kappa = 0.7798），在社区就诊的女性中，一致性极好（kappa = 0.8659）。两种kappa 系数的估计值与总体kappa 系数（p < 0.001）相比均具有高度显著性。总体而言，三分之一的正常女性乳房具有绝对光滑的纹理。
结论
开发的用于非离散性肿块性乳房的客观评估的用户友好工具具有极好的可靠性和有效性。该工具应该对良性乳腺疾病的临床药物试验以及广泛的患者常规临床记录有用。
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