Sickles E A
Department of Radiology, University of California School of Medicine, San Francisco 94143-0628.
Radiology. 1994 Aug;192(2):439-42. doi: 10.1148/radiology.192.2.8029411.
To determine whether lesion size and patient age should prompt immediate biopsy of selected nonpalpable, circumscribed, noncalcified solid (probably benign) breast masses, which otherwise would be managed with periodic mammographic surveillance.
Consecutive cases of probably benign breast masses were studied, for which mammographic surveillance was recommended prospectively. Patient age and lesion size were recorded, but age and size thresholds were not used as eligibility criteria. Clinical outcome, determined for each patient after 3 or 3 1/2 years of surveillance, was evaluated as a function of patient age and lesion size.
There were 1,403 study cases, among which 19 cancers were diagnosed (positive predictive value [PPV] = 1.4%). Only small differences were found in PPV for various patient-age and lesion-size subgroups. Even the subgroup with the highest PPV, which consisted of women aged 50 years and older, contained 60 benign masses for each cancer.
Nonpalpable, circumscribed, noncalcified (probably benign) breast masses should be managed with periodic mammographic surveillance regardless of lesion size and patient age.
确定病变大小和患者年龄是否应促使对某些无法触及、边界清晰、无钙化的实性（可能为良性）乳腺肿块立即进行活检，否则这些肿块将通过定期乳腺钼靶检查进行监测。
对连续的可能为良性乳腺肿块病例进行研究，前瞻性地建议对这些病例进行乳腺钼靶检查监测。记录患者年龄和病变大小，但年龄和大小阈值不作为纳入标准。在监测3年或3年半后确定每位患者的临床结果，并根据患者年龄和病变大小进行评估。
共有1403例研究病例，其中19例被诊断为癌症（阳性预测值[PPV]=1.4%）。在不同患者年龄和病变大小亚组的PPV中仅发现微小差异。即使是PPV最高的亚组，即年龄在50岁及以上的女性，每例癌症也有60个良性肿块。
对于无法触及、边界清晰、无钙化（可能为良性）的乳腺肿块，无论病变大小和患者年龄如何，都应通过定期乳腺钼靶检查进行监测。
