Brand I R, Sapherson D A, Brown T S
Department of Diagnostic Radiology, Bradford Royal Infirmary, UK.
Br J Radiol. 1993 May;66(785):394-7. doi: 10.1259/0007-1285-66-785-394.
With the increasing utilization of mammography, young women under the age of 35 are being referred for mammographic examination more frequently. A review of the mammograms of 159 consecutive patients aged under 35 was conducted to evaluate the clinical value of the examination in the age group for whom the probability of malignancy is low. 74% of patients referred had no discrete palpable mass and presented predominantly with lumpy or tender breasts, the remaining 24% had a discrete palpable mass. In neither group did radiographic examination beneficially influence clinical management. We propose protocol where no imaging is performed in women under 35 in the absence of a palpable mass unless there is a localized bloody discharge or a strong family history or previous personal history of breast cancer. In patients with a palpable mass, ultrasound should be performed initially to identify simple cysts and if negative only then progressing to mammography.
随着乳腺X线摄影的使用日益增多，35岁以下的年轻女性接受乳腺X线检查的频率也越来越高。我们对159例连续的35岁以下患者的乳腺X线片进行了回顾，以评估该检查在恶性肿瘤可能性较低的这一年龄组中的临床价值。转诊患者中有74%没有可触及的离散肿块，主要表现为乳房结块或压痛，其余24%有可触及的离散肿块。在这两组中，影像学检查均未对临床管理产生有益影响。我们建议制定这样的方案：35岁以下无可触及肿块的女性，除非有局部血性溢液、强烈的家族病史或既往个人乳腺癌病史，否则不进行影像学检查。对于有可触及肿块的患者，应首先进行超声检查以识别单纯囊肿，若结果为阴性，再进行乳腺X线摄影。
