Hillhouse R A, Norvill K A, Buchanan S W, McFaul R B, Stone D A, Wilson C T
University of North Texas Health Science Center, Fort Worth-Texas College of Osteopathic Medicine, USA.
J Am Osteopath Assoc. 1996 Jul;96(7):398-400.
The medical records of 192 women with nonpalpable mammographically detected breast lesions who underwent needle-localized breast biopsy between January 1989 and January 1991 and between March 1992 and March 1994 were reviewed. Of the 192 patients examined, 100 underwent biopsy for evaluation of microcalcifications suggestive of malignancy. Ninety-two biopsies were performed for non-specific radiodensities not inclusive of microcalcifications. This study examines the radiographic characteristics of the nonpalpable breast lesion. Although presence of microcalcifications on mammograms are an important finding in detection of breast carcinoma, it must not be considered pathognomonic. Other distinguishing factors require evaluation to assess the indication for biopsy. Central to this study was the presence of microcalcifications alone or as detected in association with a dominant mass. Cancer was discriminated in 38 (20%) of the patients studied. Mammographic findings with microcalcification, regardless of the presence of a mass, were found to be malignant in 20% of patients undergoing biopsy. Nine percent of biopsies done to evaluate microcalcifications alone were malignant. The finding of microcalcification associated with a dominant mass proved malignant in 34% of patients who had a biopsy done. The authors include guidelines for increasing the effectiveness of needle-localized biopsies of the breast.
回顾了1989年1月至1991年1月以及1992年3月至1994年3月期间192例乳房X线摄影检测到不可触及乳腺病变并接受针吸定位乳腺活检的女性的病历。在这192例接受检查的患者中，100例因怀疑恶性微钙化而接受活检。92例活检是针对不包括微钙化的非特异性放射密度进行的。本研究探讨了不可触及乳腺病变的影像学特征。虽然乳房X线摄影上微钙化的存在是检测乳腺癌的重要发现，但不能将其视为具有确诊意义。还需要评估其他鉴别因素以评估活检的指征。本研究的核心是单独存在微钙化或与优势肿块相关联时检测到微钙化。在所研究的患者中，38例（20%）诊断为癌症。乳房X线摄影有微钙化表现的患者，无论是否存在肿块，在接受活检的患者中有20%被发现为恶性。仅为评估微钙化而进行的活检中有9%为恶性。与优势肿块相关的微钙化在接受活检的患者中有34%被证明为恶性。作者还纳入了提高乳腺针吸定位活检有效性的指导原则。
