Tsuchiya A, Nakayama K, Urazumi K, Kimijima I, Abe R
Dept. of Surgery II, Fukushima Medical College.
Gan To Kagaku Ryoho. 1994 Jun;21 Suppl 2:148-52.
To improve the survival in breast cancer, it is important to detect and treat breast cancer early. Physical examination (PE), mammography (MMG), ultrasonography (US), and aspiration biopsy cytology (ABC) are routinely assessed in the diagnosis of breast cancer. When three procedures including ABC are positive in a diagnosis of breast cancer, it is an absolute indication for surgery. Of all 238 breast cancers between 1987 and 1992, 86 cases were T1. The sensitivity of each procedure was PE 58.9%, MMG 70.0%, US 74.4% and ABC 86.2%, indicating that PE was less sensitive for small cancer. The recent accuracy of ABC in our series was satisfactory, and the combination diagnosis had a good result for T1 tumor because the findings from these procedures were complimentary. The high accuracy of ABC therefore suggests that lumpectomy has two aspects, definite diagnosis, and therapy as conservative surgery for breast cancer. The nineteen cases of T0 cancer encountered were almost entirely detected by nipple discharge or MMG. In conclusion, the combination diagnosis including ABC was very effective, and it is very important to detect and diagnose clinically small or non-palpable breast cancer.
为提高乳腺癌患者的生存率，早期发现和治疗乳腺癌至关重要。在乳腺癌诊断中，通常会对体格检查（PE）、乳房X线摄影（MMG）、超声检查（US）和针吸活检细胞学检查（ABC）进行评估。当包括ABC在内的三项检查在乳腺癌诊断中呈阳性时，即为手术的绝对指征。在1987年至1992年间的所有238例乳腺癌中，86例为T1期。各项检查的敏感性分别为：PE 58.9%、MMG 70.0%、US 74.4%、ABC 86.2%，这表明PE对小癌的敏感性较低。在我们的系列研究中，ABC最近的准确性令人满意，联合诊断对T1期肿瘤效果良好，因为这些检查的结果具有互补性。因此，ABC的高准确性表明，肿块切除术具有两个方面的作用，即明确诊断以及作为乳腺癌的保守手术治疗手段。遇到的19例T0期癌症几乎全部通过乳头溢液或MMG检测出来。总之，包括ABC在内的联合诊断非常有效，临床检测和诊断小的或不可触及的乳腺癌非常重要。
