Briffod M, De Maublanc M A
Centre René Huguenin de Lutte contre le Cancer, Saint-Cloud.
Arch Anat Cytol Pathol. 1998;46(4):251-6.
Diagnostic difficulties can arise during the cytologic diagnosis of almost all types of breast lesions. "True" difficulties, which are discussed herein, should be differentiated from difficulties due to faulty technique. The frequency of diagnostic difficulties varies across lesions: the proportion of "suspicious" specimens is 4% in adenofibroma, 5 to 7% in cancer, and 17% in epithelial duct hyperplasia, and the false-negative rate in cancer is 3 to 5%. Many difficulties can be overcome by a good knowledge of breast cytopathology. Others are insuperable and should remain so to avoid diagnostic mistakes. In these cases, which should be considered "suspicious", the clearly written documented report should request a histological study. The distinction between duct carcinoma and lobular carcinoma remains difficult, and that between invasive carcinoma and intraductal carcinoma requires a histologic study.
在几乎所有类型的乳腺病变的细胞学诊断过程中都可能出现诊断困难。本文所讨论的“真正的”困难应与技术失误导致的困难区分开来。诊断困难的发生率因病变类型而异：腺纤维瘤中“可疑”标本的比例为4%，癌症中为5%至7%，上皮导管增生中为17%，癌症的假阴性率为3%至5%。通过对乳腺细胞病理学的充分了解，许多困难是可以克服的。其他一些困难是无法克服的，并且应该保持这种状态以避免诊断错误。在这些应被视为“可疑”的病例中，清晰书写的记录报告应要求进行组织学研究。导管癌和小叶癌之间的区分仍然困难，浸润性癌和导管内癌之间的区分需要进行组织学研究。
