Opie H, Estes N C, Jewell W R, Chang C H, Thomas J A, Estes M A
University of Kansas Medical Center, Kansas City.
Am Surg. 1993 Aug;59(8):490-3; discussion 493-4.
The purpose of this study was to determine our yield of carcinoma in patients with a nonpalpable mammographic abnormality and to identify which mammographic criteria will most likely yield a positive biopsy. We conducted a review of all patients with nonpalpable mammographic abnormality who underwent needle-localized breast biopsy at our institution from 1988 to 1991. Charts of 295 patients who underwent 332 needle-localized breast biopsy were reviewed for age, family history, cancer history, mammographic findings, operative time, volume of excised breast tissue, and histology. Mammographic abnormalities were categorized as suspicious (clustered) microcalcification, stellate mass, ill-defined mass, well-circumscribed mass, developing density, or asymmetric density. The overall yield of cancer positive biopsies was 48 of 332 (14.5%). The frequency of diagnosed cancers was DCIS (8), LCIS (1), Stage I (31) and Stage II (8). The frequency that each single mammographic criteria resulted in a cancer diagnosis was: suspicious calcification (12%), stellate mass (22%), ill-defined mass (14%), well-circumscribed mass (11%), developing density (9%) and asymmetric density (0%). However, patients with both a stellate mass and microcalcifications formed the highest risk subgroup, with cancer detected 66 per cent of the time (P = 0.03).
本研究的目的是确定乳腺钼靶检查发现异常但触诊阴性的患者中癌的检出率，并确定哪些乳腺钼靶标准最有可能活检阳性。我们回顾了1988年至1991年在本机构接受针定位乳腺活检的所有乳腺钼靶检查发现异常但触诊阴性的患者。对295例接受332次针定位乳腺活检患者的病历进行了回顾，记录了患者的年龄、家族史、癌症史、乳腺钼靶检查结果、手术时间、切除乳腺组织的体积以及组织学情况。乳腺钼靶异常分为可疑（成簇）微钙化、星芒状肿块、边界不清的肿块、边界清晰的肿块、密度增加影或不对称密度影。活检阳性确诊癌症的总体检出率为332例中的48例（14.5%）。确诊癌症的频率为导管原位癌（8例）、小叶原位癌（1例）、I期（31例）和II期（8例）。每个单一乳腺钼靶标准导致癌症诊断的频率为：可疑钙化（12%）、星芒状肿块（22%）、边界不清的肿块（14%）、边界清晰的肿块（11%）、密度增加影（9%）和不对称密度影（0%）。然而，既有星芒状肿块又有微钙化的患者形成了最高风险亚组，癌症检出率为66%（P = 0.03）。
