大量女性即使在一年内正常乳房 X 光检查后也会出现可触及的乳腺癌。

A significant number of women present with palpable breast cancer even with a normal mammogram within 1 year.

机构信息

Department of Surgery, Mayo Clinic, Phoenix, AZ 85054, USA.

出版信息

Am J Surg. 2010 Dec;200(6):712-7; discussion 717-8. doi: 10.1016/j.amjsurg.2010.08.005.

DOI:10.1016/j.amjsurg.2010.08.005

PMID:21146009

Abstract

BACKGROUND

Although mammography is the gold standard for breast cancer screening, clinical breast examination (CBE) and self breast examination (SBE) are important adjuncts whose utility has been questioned.

METHODS

A retrospective review of invasive breast cancer patients from 2000 to 2008 was performed. We compared 3 groups: breast cancer detected by (1) imaging only (nonpalpable) or palpable mass with a normal mammogram (2) ≥ 1 year (mammogram ≥ 1 year) or (3) <1 year (mammogram <1 year).

RESULTS

Of 1,222 women, presentation included 67% nonpalpable, 21% mammogram ≥ 1 year, and 13% mammogram <1 year. Patients presenting with palpable masses on SBE or CBE even with a normal mammogram within 1 year tended to have more aggressive tumors (larger size, lymph node positive, and triple-negative disease) resulting in more aggressive therapy (a higher mastectomy rate and a greater likelihood of chemotherapy).

CONCLUSION

A significant number of women present with palpable breast cancer within 1 year of a normal mammogram, many with an aggressive cancer. Therefore, we continue to advocate SBE and CBE for breast cancer screening.

摘要

背景

尽管乳腺 X 线摄影术是乳腺癌筛查的金标准，但临床乳房检查（CBE）和自我乳房检查（SBE）也是重要的辅助手段，其效用一直存在争议。

方法

对 2000 年至 2008 年期间的浸润性乳腺癌患者进行回顾性分析。我们比较了 3 组患者：（1）仅通过影像学（触诊阴性）或触诊可及伴正常乳腺 X 线片发现的乳腺癌；（2）≥1 年（乳腺 X 线片≥1 年）；或（3）<1 年（乳腺 X 线片<1 年）。

结果

在 1222 名女性中，表现为触诊阴性者占 67%，乳腺 X 线片≥1 年者占 21%，乳腺 X 线片<1 年者占 13%。即使在 1 年内通过 SBE 或 CBE 触诊发现了可触及的肿块且乳腺 X 线片正常，患者的肿瘤也往往更具侵袭性（更大的肿瘤大小、淋巴结阳性和三阴性疾病），从而导致更具侵袭性的治疗（更高的乳房切除术率和更有可能接受化疗）。