乳腺微小癌的临床诊断

目的探讨肿块直径＜1.0 cm乳腺微小癌的临床诊断方法.方法对194例乳腺微小癌的临床检查,钼靶X线检查以及超声检查结果进行综合分析.结果临床检查:194例乳腺微小癌均为单发;肿块质地硬、活动差、边界不清的临床诊断阳性率高于肿块质地韧、软、活动好、边界清者;腋下触及淋巴的结临床诊断阳性率低于腋下未触及淋巴结者.钼靶X线检查:肿块影和细砂钙化与结构不良及腺体致密的钼靶X线表现相比,诊断阳性率高,平均年龄大.超声检查:数字彩色超声检查诊断乳腺微小癌阳性率高于普通B型超声检查.超声诊断可疑癌和乳腺癌的平均年龄大于超声诊断纤维瘤和增生结节的平均年龄.结论严格掌握乳腺微小肿块的临床诊断标准,高度注意钼靶X线片肿块影及细砂钙化表现,对腺体结构不良及腺体致密者不能轻率诊断良性.数字彩色超声检查可提高乳腺微小癌检查的阳性率.

Clinical diagnosis of minimal breast cancer

Objective To explore clinical diagnosis of minimal breast cancer with diameter equal to 1cm or less. Method The clinical, molybdenum target tube radiographic and ultrasound manifestations of 194 minimal breast cancer patients admitted to Tianjin Medical University Cancer Hospital between 1996 and 2001 were analyzed. Results Clinical manifestation; All 194 minimal breast cancers were unilateral. The clinical diagnostic positive rate of firm and poorly movable tumor with unclear boundary was higher than that of soft and easily movable tumor with clear boundary. The clinical diagnostic positive rate of tumors with palpable axillary lymph nodes was lower than that with impalpable axillary lymph nodes. Molybdenum target tube radiographic manifestations: The diagnostic positive rate of mass and fine grain calcification was obviously higher than that of cacoethic construction and dense gland and the mean age of the patients was older. Ultrasound manifestations:The diagnostic positive rate by digital color ultrasound examination was higher than that by ordinary ultrasound examination. Conclusion The clinical diagnostic criteria for minimal breast cancer should be strictly mastered. Attention should be paid to mass and fine grain calcification in molybdenum target tube radiography. Cacoethic construction and dense gland manifestation can not be simply diagnosed as benign lesion. Digital color ultrasound examination can increase diagnostic positive rate of minimal breast cancer.