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在阿尔巴尼亚乳腺密度较高且病变超过2厘米的女性中,联合使用乳房X光检查和超声检查结果检测恶性肿瘤的协同作用。

Synergy in combining findings from mammography and ultrasonography in detecting malignancy in women with higher density breasts and lesions over 2 cm in Albania.

作者信息

Malaj Altin, Shahini Albana

机构信息

LOGOS University, Tirana, Albania.

American Hospital, Tirana, Albania.

出版信息

Contemp Oncol (Pozn). 2016;20(6):475-480. doi: 10.5114/wo.2016.65608. Epub 2017 Jan 12.

Abstract

AIM OF THE STUDY

To provide evidence of the synergy of combining findings from mammography (MM) and ultrasonography (US) in detecting malignancy in women with high-density breasts.

MATERIAL AND METHODS

A total of 245 women were screened for breast cancer using both mammography and ultrasonography at the American Hospital in Tirana during 2013-2014. The data was used to identify possible benefits in detecting malignancy, by combining the findings of MM and US and confirming them with those of the biopsy. Data on age, breast density, BI-RADS classification, and biopsy confirmations were collected and analysed.

RESULTS

Out of the 245 women, 36 biopsies were taken (17 for women classified BI-RADS 4 and 5; 19 for women with BI-RADS 3 that had grown in size from the previous examination). The accuracy in detecting malignancy for low-density-breast women was 90% for MM, 70% for US, and 90% for combined. For high-density breasts, the accuracy was 65% for MM, 79% for US, and 82% for combined findings. Multivariate analysis indicates that high-density-breast women who have a malignant finding in at least one of the examinations (MM or US) are 24 times more likely ( = 0.039) to have a positive finding in biopsy for malignancy. The odds increased 32 times for lesions over 2 cm ( = 0.056).

CONCLUSIONS

Our study results indicate additional benefits of combining findings from MM and US for high-density-breast women. Further study is warranted in a larger population and for different kinds of cancer.

摘要

研究目的

提供乳腺钼靶(MM)和超声检查(US)相结合在检测高密度乳房女性恶性肿瘤方面协同作用的证据。

材料与方法

2013年至2014年期间,在地拉那的美国医院,共有245名女性同时接受了乳腺钼靶和超声检查以筛查乳腺癌。通过结合乳腺钼靶和超声检查结果并与活检结果进行对比,该数据用于确定在检测恶性肿瘤方面的潜在益处。收集并分析了年龄、乳房密度、BI-RADS分类和活检确认等数据。

结果

在245名女性中,共进行了36次活检(17次针对BI-RADS 4和5级分类的女性;19次针对BI-RADS 3级且相较于上次检查增大的女性)。低密度乳房女性检测恶性肿瘤的准确率,乳腺钼靶为90%,超声为70%,联合检查为90%。对于高密度乳房,乳腺钼靶的准确率为65%,超声为79%,联合检查结果为82%。多变量分析表明,在至少一项检查(乳腺钼靶或超声)中发现恶性病变的高密度乳房女性,活检发现恶性病变阳性的可能性要高24倍(P = 0.039)。对于直径超过2厘米的病变,这一几率增加了32倍(P = 0.056)。

结论

我们的研究结果表明,对于高密度乳房女性,结合乳腺钼靶和超声检查结果具有额外的益处。有必要在更大规模的人群中针对不同类型的癌症开展进一步研究。

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本文引用的文献

1
Digital Mammography in Young Women: Is a Single View Sufficient?年轻女性的数字化乳腺摄影:单视图是否足够?
J Clin Diagn Res. 2016 Mar;10(3):TC10-2. doi: 10.7860/JCDR/2016/17342.7502. Epub 2016 Mar 1.
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Body weight and sensitivity of screening mammography.
Eur J Cancer. 2016 Jun;60:93-100. doi: 10.1016/j.ejca.2016.02.028. Epub 2016 Apr 14.
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Missed Breast Cancer: What Can We Learn?漏诊的乳腺癌:我们能学到什么?
Curr Probl Diagn Radiol. 2016 Nov-Dec;45(6):402-419. doi: 10.1067/j.cpradiol.2016.03.001. Epub 2016 Mar 9.
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