Egan R L, Dolan P D
Department of Radiology, Emory University, Atlanta 30322.
Acta Radiol. 1988 Sep-Oct;29(5):497-503.
Non-invasive optical spectroscopy consistently delineates compositional and physiologic properties of breast tissues serving as a pre-mammography risk marker for cancer or yielding a high assurance of no such risk. We believe this new non-imaging approach depends on biochemistry of tissues rather than on the macroscopic physical properties involved with most breast imaging modalities. After establishing the procedure as inexpensive, physician independent, simple, requiring only a few minutes and appealing to women, it was carried out in two institutions on 1739 women referred for routine mammography. Of 166 breast biopsies on these women 77 were cancer by histology. An automated computerized analysis of the spectroscopic data yielded a sensitivity of 87 per cent, a specificity of 74 per cent and a negative predictive value of 99 per cent. Optical spectroscopy shows promise in identifying women at a higher risk for developing cancer, cases of non-infiltration carcinomas where dense breasts limit mammographic detection, and even clustered calcifications not associated with a mass. The relative risk of breast cancer was 16.5 times as great with a positive spectroscopic value at a sensitivity range of 87 per cent. Placement of 87 per cent of all breast cancer cases in a subset of 28.7 per cent of all women will yield a population of women in whom mammography will be approximately four times as efficient.
非侵入性光学光谱法能够持续描绘乳腺组织的成分和生理特性,可作为乳腺癌的乳腺钼靶检查前风险标志物,或者提供不存在此类风险的高度确定性。我们认为这种新的非成像方法取决于组织的生物化学特性,而非大多数乳腺成像模式所涉及的宏观物理特性。在确定该检查方法价格低廉、无需医生操作、简单、仅需几分钟且对女性有吸引力之后,在两家机构对1739名转诊进行常规乳腺钼靶检查的女性进行了该检查。这些女性中有166例进行了乳腺活检,其中77例经组织学检查确诊为癌症。对光谱数据进行的自动化计算机分析得出的敏感度为87%,特异度为74%,阴性预测值为99%。光学光谱法在识别患癌风险较高的女性、致密乳腺限制乳腺钼靶检测的非浸润性癌病例,甚至与肿块无关的簇状钙化方面显示出前景。在敏感度为87%的情况下,光谱值为阳性时患乳腺癌的相对风险是原来的16.5倍。将所有乳腺癌病例的87%置于所有女性的28.7%这一子集中,将得到一个群体,在该群体中乳腺钼靶检查的效率将提高约四倍。