Warwick D J, Smallwood J A, Guyer P B, Dewbury K C, Taylor I
University Surgical Unit, Royal South Hampshire Hospital, Southampton, UK.
Br J Surg. 1988 Mar;75(3):243-5. doi: 10.1002/bjs.1800750319.
In this centre, ultrasound mammography has been shown to be more accurate in elucidating the nature of palpable breast lesions than X-ray mammography. A prospective study was devised to determine whether this accuracy could be translated into improved management of patients with breast carcinoma. A total of 223 patients with palpable breast masses were assessed by clinical examination, imaging (X-ray and ultrasound mammography) and aspiration cytology. Each was scored on a five-point scale and treatment was planned according to the total score. According to the protocol, an adequate total score would permit definitive surgery avoiding frozen section. By using sonography rather than radiology, the number of correct diagnoses could be improved by 25 per cent. This was because the greater sensitivity of ultrasound (92.8 per cent) compared to X-ray mammography (82.5 per cent) was reflected in a higher total score, which was sufficient to allow definitive surgical treatment without prior histological confirmation of diagnosis.
在本中心，已证明超声乳腺造影在阐明可触及乳腺病变的性质方面比X线乳腺造影更准确。设计了一项前瞻性研究，以确定这种准确性是否能转化为对乳腺癌患者更好的治疗。共有223例可触及乳腺肿块的患者接受了临床检查、影像学检查（X线和超声乳腺造影）和细针穿刺细胞学检查。每项检查按五分制评分，并根据总分制定治疗方案。根据方案，足够的总分将允许进行确定性手术，避免术中冰冻切片检查。通过使用超声检查而非放射学检查，正确诊断的数量可提高25%。这是因为超声的更高敏感性（92.8%）与X线乳腺造影（82.5%）相比，体现在更高的总分上，这足以允许在没有术前组织学确诊的情况下进行确定性手术治疗。
