Hardy J R, Powles T J, Judson I, Heron C, Williams M, Cherryman G, Husband J, Cosgrove D, Blaszcyzyk M, Sinnett H D
Department of Radiology, Royal Marsden Hospital, Sutton, Surrey, UK.
Clin Oncol (R Coll Radiol). 1990 May;2(3):148-52. doi: 10.1016/s0936-6555(05)80148-7.
Palpable breast nodules in 143 patients attending our primary diagnosis breast clinics were assessed by clinical examination, needle cytology, mammography, ultrasonography and magnetic resonance imaging (MRI). The diagnostic accuracy of all test combinations was compared with the final diagnosis of malignant or benign disease. Two-test combinations increased the sensitivity of diagnosis over that of the individual tests to between 93% and 100% except for MRI/mammography and MRI/cytology. The combinations of three or more tests increased the sensitivity further, but at the expense of an increased false-positive rate. MRI does not appear to have an important role in the primary diagnosis of breast cancer. Mammography is necessary because of the possibility of occult or multifocal disease. Clinical examination was associated with a high false-positive rate. The combination of cytology and ultrasound was best at correctly diagnosing malignancy, but in this series only 42% of patients underwent ultrasound examination. The role of breast ultrasound together with needle aspiration cytology for the diagnosis of malignancy in palpable breast nodules deserves further evaluation.
对在我们的初级诊断乳腺诊所就诊的143例可触及乳腺结节患者进行了临床检查、针吸细胞学检查、乳房X线摄影、超声检查和磁共振成像（MRI）评估。将所有检测组合的诊断准确性与恶性或良性疾病的最终诊断结果进行比较。除了MRI/乳房X线摄影和MRI/细胞学检查外，两项检测组合的诊断敏感性比单项检测提高到93%至100%之间。三项或更多项检测的组合进一步提高了敏感性，但以假阳性率增加为代价。MRI在乳腺癌的初级诊断中似乎没有重要作用。由于存在隐匿性或多灶性疾病的可能性，乳房X线摄影是必要的。临床检查的假阳性率较高。细胞学检查和超声检查的组合在正确诊断恶性肿瘤方面效果最佳，但在本系列中只有42%的患者接受了超声检查。乳腺超声联合针吸细胞学检查在诊断可触及乳腺结节中的恶性肿瘤方面的作用值得进一步评估。
