Skaane P, Kåresen R, Jacobsen U, Amlie E, Sauer T, Skjørten F
Røntgenavdelingen, Ullevål sykehus, Oslo.
Tidsskr Nor Laegeforen. 1995 Jun 20;115(16):1965-9.
The evaluation of patients with a palpable breast lump includes physical examination, mammography, and fine needle aspiration cytology. Combined use of these diagnostic procedures (triple diagnostic) gives nearly the same degree of accuracy as excisional biopsy with a sensitivity of 97-99% in patients with palpable breast carcinomas. Ultrasonography is a valuable adjunct when mammography is normal or nonconclusive and should be the primary imaging modality in patients under 35 years of age with benign findings on physical examination. Ongoing quality assessment of mammography and ultrasonography is mandatory, since the imaging modalities play a central role in the evaluation of patients with lumps in the breast. There are considerable practical problems associated with the medical audit of the triple diagnostic procedure. Aspects of the evaluation of breast lumps and organization of breast imaging centres are discussed in the light of our own experiences.
对可触及乳腺肿块患者的评估包括体格检查、乳房X线摄影及细针穿刺细胞学检查。联合应用这些诊断程序（三联诊断）所获得的准确率与切除活检相近，对于可触及乳腺癌患者，其敏感性为97-99%。当乳房X线摄影正常或结果不明确时，超声检查是一项有价值的辅助检查，对于35岁以下体格检查有良性发现的患者，超声应作为主要的成像方式。必须持续对乳房X线摄影和超声检查进行质量评估，因为这些成像方式在乳腺肿块患者的评估中起着核心作用。三联诊断程序的医学审核存在相当多实际问题。结合我们自己的经验，对乳腺肿块评估及乳腺成像中心的组织安排等方面进行了讨论。
