Dixon J M, Anderson T J, Lamb J, Nixon S J, Forrest A P
Br J Surg. 1984 Aug;71(8):593-6. doi: 10.1002/bjs.1800710809.
The accuracy of clinical examination, mammography and fine needle aspiration cytology in identifying malignancy has been assessed in 1655 breast masses from two time periods. Clinical examination and mammography remained consistent at identifying malignancy but 9 per cent of all breast carcinomas were considered benign by both techniques (sensitivity 91 per cent). Fine needle aspiration cytology, when performed by multiple aspirators in the first study period, had a sensitivity of only 66 per cent for malignancy. During the second period of study, when all aspirates were performed by a single aspirator, sensitivity rose to 99 per cent. The two patients with false negative cytology in this latter period had both clinical and mammographic evidence of malignancy. No patient with malignant cytology was subsequently shown to have benign disease. It is concluded that a combination of clinical examination and mammography, with fine needle aspiration cytology performed by committed individuals with aptitude for the technique and interpreted by experienced pathologists, can identify all patients with breast cancer before surgery.
在两个时间段的1655例乳腺肿块中，评估了临床检查、乳房X线摄影及细针穿刺细胞学检查在鉴别恶性肿瘤方面的准确性。临床检查和乳房X线摄影在鉴别恶性肿瘤方面保持一致，但两种技术均将所有乳腺癌中的9%判定为良性（敏感性91%）。在第一个研究阶段，由多名抽吸者进行细针穿刺细胞学检查时，对恶性肿瘤的敏感性仅为66%。在第二个研究阶段，当所有抽吸均由一名抽吸者进行时，敏感性升至99%。在后一阶段有两例细胞学检查假阴性的患者具有临床和乳房X线摄影的恶性证据。没有细胞学检查为恶性的患者随后被证明患有良性疾病。结论是，临床检查和乳房X线摄影相结合，由有技术资质且经验丰富的病理学家进行解释的细针穿刺细胞学检查，能够在手术前识别所有乳腺癌患者。
