Abe R, Nakayama K, Takada M
Second Dept. of Surgery, Fukushima Medical College, Japan.
Gan To Kagaku Ryoho. 1994 Dec;21(16):2713-9.
Various kinds of modalities have been used to detect and diagnose breast cancer. In order to detect early breast cancer, mass screening has been widely performed with physical examinations in Japan and mammography in the U. S and European countries. After detecting some abnormalities within the breast under basic screening, further examinations are required for a precise diagnosis. For this purpose, ultrasonography and/or thermography are used as a noninvasive image examination, and aspiration biopsy cytology and/or surgical biopsy are employed for the final diagnosis. Mammography with highly qualified equipment and its adequate performance is thought to be the most useful modality in basic screening for detecting nonpalpable breast cancer. Ultrasonography is valuable for differentiating whether the lesions detected on screening are malignant or benign. Thermography seems better in analysing the malignant potential of the lesions detected by other examinations. Aspiration biopsy cytology (ABC) is employed for final diagnosis. Fine needle ABC has the highest sensitivity (90.8%) compared to other modalities in this department of Fukushima Medical College Hospital. Positive diagnosis on ABC is not needed for surgical biopsy. However, suspected or negative findings on ABC are required for two-step surgical biopsy which should be performed at the outpatient clinic to obtain detailed information about the biological characteristics as well as pathological diagnosis.
已经使用了各种方法来检测和诊断乳腺癌。为了早期发现乳腺癌,在日本通过体格检查、在美国和欧洲国家通过乳房X线摄影术广泛开展了大规模筛查。在基础筛查中检测到乳房内有一些异常后,需要进一步检查以进行精确诊断。为此,超声检查和/或热成像被用作非侵入性影像检查,而针吸活检细胞学检查和/或手术活检用于最终诊断。配备高质量设备且性能良好的乳房X线摄影术被认为是基础筛查中检测不可触及乳腺癌最有用的方法。超声检查对于鉴别筛查中发现的病变是恶性还是良性很有价值。热成像在分析其他检查发现的病变的恶性潜能方面似乎更具优势。针吸活检细胞学检查(ABC)用于最终诊断。在福岛医学院附属医院的这个科室,细针ABC与其他方法相比具有最高的敏感性(90.8%)。手术活检不需要ABC的阳性诊断。然而,ABC的可疑或阴性结果对于两步手术活检是必需的,两步手术活检应在门诊进行,以获取有关生物学特征以及病理诊断的详细信息。