Akbari Mohammad Esmaeil, Haghighatkhah Hamidreza, Shafiee Mohammad, Akbari Atieh, Bahmanpoor Mitra, Khayamzadeh Maryam
Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Asian Pac J Cancer Prev. 2012;13(5):1907-10. doi: 10.7314/apjcp.2012.13.5.1907.
Breast cancer is the most prevalent cancer and the fifth cause of cancer death in Iranian women. Early detection and treatment are important for appropriate management of this disease. Mammography and ultrasonography are used for screening and evaluation of symptomatic cases and the main diagnostic test for breast cancer is pathological. In this study we evaluated mammography and ultrasonography as diagnostic tools.
In this cross-sectional study 384 mammography and ultrasonography reports for 255 women were assessed, divided into benign and malignant groups. Suspected cases were referred for pathology evaluation. The radiologic and pathologic reports were compared and also comparison was performed based on age groups (more and less than 50 years old), history of breastfeeding and gravidity. Statistical analysis was performed by SPSS.
The mean ages of malignant and benign cases were 49±11.6 and 43±11.2 years, respectively. Sensitivity and specificity for mammography were 73% and 45%, respectively. Sensitivity and specificity for ultrasonography were 69% and 49%, respectively. There were statistical differences between specificity of mammography in patients based on factors such as history of gravidity, breastfeeding and sensitivity in patients equal or more than 50 years old and less.
Factors affecting different results in mammography and ultrasonography reports were classified into three groups, consisting of skill, experience and training of medical staff, and setting of instruments. It is recommended that health managers in developing countries pay attention the quality of setting and man power more than current status. Policy-makers and managers must establish guidelines regarding breast imaging in Iran.
乳腺癌是伊朗女性中最常见的癌症，也是癌症死亡的第五大原因。早期发现和治疗对于该疾病的合理管理至关重要。乳房X线摄影和超声检查用于筛查和评估有症状的病例，而乳腺癌的主要诊断测试是病理学检查。在本研究中，我们评估了乳房X线摄影和超声检查作为诊断工具的情况。
在这项横断面研究中，评估了255名女性的384份乳房X线摄影和超声检查报告，分为良性和恶性组。疑似病例被转诊进行病理学评估。比较了放射学和病理学报告，并根据年龄组（50岁及以上和50岁以下）、母乳喂养史和妊娠史进行了比较。使用SPSS进行统计分析。
恶性和良性病例的平均年龄分别为49±11.6岁和43±11.2岁。乳房X线摄影的敏感性和特异性分别为73%和45%。超声检查的敏感性和特异性分别为69%和49%。根据妊娠史、母乳喂养史等因素，50岁及以上和50岁以下患者的乳房X线摄影特异性存在统计学差异。
影响乳房X线摄影和超声检查报告不同结果的因素分为三类，包括医务人员的技能、经验和培训以及仪器设备的设置。建议发展中国家的卫生管理人员更多地关注设备设置和人力质量，而非当前状况。政策制定者和管理人员必须制定伊朗乳房成像的指南。
