Brittenden J, Watmough D, Heys S D, Eremin O
Department of Surgery, University of Aberdeen, UK.
Br J Radiol. 1995 Dec;68(816):1344-8. doi: 10.1259/0007-1285-68-816-1344.
Mammography is widely used for imaging the breast, but is known to be less effective in evaluating the younger dense breast. In this study the ability of telediaphanography in conjunction with Doppler ultrasound (TDDU) to detect breast carcinomas was assessed. Light absorption, determined by the number of blood cells per unit volume of breast, results in the detection of an opaque lesion. Subsequent Doppler ultrasound detects the neovascularization at the periphery of tumours. In total, 178 patients were investigated without prior knowledge of the mammographic findings. This consisted of 69 patients presenting to the symptomatic breast clinic with normal mammograms and 109 patients with mammographic detected abnormalities (mean age 54 years). There were 95 neoplastic lesions. The sensitivity and specificity were: telediaphanography alone 73% and 82%; TDDU 61% and 92%, respectively. TDDU was less sensitive for small and impalpable tumours, and did not detect ductal carcinoma in situ (26 false negatives, mean diameter of 1.1 cm (SD of 0.3 cm)). Subsequent Doppler ultrasound did not further increase the sensitivity of the examination, but did increase the specificity. Patients with locally advanced breast cancers showed dramatic changes on repeated optical/Doppler examinations, in concordance with response to chemotherapy. The combined optical/Doppler instrument, with its low sensitivity, is not suitable for screening, even in the young dense breast, but may have a role in assessing the response of large tumours to chemotherapy.
乳房X线摄影术被广泛用于乳房成像，但众所周知，在评估年轻的致密型乳房时效果较差。在本研究中，评估了远红外透照术联合多普勒超声（TDDU）检测乳腺癌的能力。通过单位体积乳房内血细胞数量确定的光吸收可检测出不透明病变。随后的多普勒超声可检测肿瘤周边的新生血管形成。总共对178例患者进行了研究，事先未了解其乳房X线摄影检查结果。其中包括69例乳房X线摄影检查正常但前往有症状乳房门诊就诊的患者以及109例乳房X线摄影检查发现异常的患者（平均年龄54岁）。共有95个肿瘤性病变。其敏感度和特异度分别为：单独使用远红外透照术时为73%和82%；TDDU分别为61%和92%。TDDU对小的、触诊不到的肿瘤敏感度较低，且未检测出原位导管癌（26例假阴性，平均直径1.1厘米（标准差0.3厘米））。随后的多普勒超声并未进一步提高检查的敏感度，但提高了特异度。局部晚期乳腺癌患者在重复进行光学/多普勒检查时显示出显著变化，与化疗反应一致。这种光学/多普勒联合仪器敏感度较低，即便对于年轻的致密型乳房也不适合用于筛查，但在评估大肿瘤对化疗的反应方面可能有一定作用。
