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目的通过分析年轻乳腺癌误诊病例的全数字乳腺X射线征象,总结经验以提高X射线诊断符合率。方法回顾性分析本院2011、1～2012、5以乳腺疾病就诊行乳腺X射线检查≤35岁患者。结果 329例患者,其中术后病理诊断乳腺癌为35例,5例术前X射线报告为BI-RA DS-2、3级,2例术后病理为浸润性导管癌,1例病理为导管原位癌(DCIS),1例为粘液癌,1例为炎性乳癌,2例术前诊断为BI-RAD-4、5级,术后病理1例为乳腺腺病瘤,1例为错构瘤。分析较典型征象为肿块影,边缘可见毛刺,钙化多见,以簇状、泥沙状多见,分布较密集,分析误诊病例回顾性分析与对侧对比可见局限性致密影,乳腺腺体边缘欠规则,另一例可见微小钙化,部分可见肿块影,边缘模糊并多发小钙化点,不同生理周期摄片对病变的显示有影响。结论年龄≤35岁患者乳腺以多量腺体型居多,X射线影像对比度欠佳,拍片受月经周期影响明显,误诊率较高,除典型乳腺癌X射线征象外,尤其应注意不典型X射线征象,如局限性致密影,乳管增粗,血管影增多、增粗等,需密切结合临床及其他检查必要时活检,以提高疾病检出率。
Objective To summarize the experience to improve the coincidence rate of X-ray diagnosis by analyzing the all-digital breast X-ray signs of misdiagnosed cases of young breast cancer. Methods Retrospective analysis of our hospital 2011,1 ~ 2012,5 to breast disease treatment line mammography ≤ 35 years old patients. Results Among 329 patients, postoperative pathological diagnosis of breast cancer was 35 cases, 5 cases of preoperative X-ray were reported as BI-RA DS-2 and 3, 2 cases of invasive ductal pathology, 1 case of pathological duct In situ carcinoma (DCIS), 1 case of mucinous carcinoma, 1 case of inflammatory breast cancer, 2 cases of preoperative diagnosis of BI-RAD-4, 5, postoperative pathology in 1 case of breast adenoma, 1 case of wrong Tumor. Analysis of the typical signs of mass than the shadow, the edge of the visible burr, more common calcification, clustered, muddy more common, more dense distribution, the analysis of misdiagnosed cases of retrospective analysis and contralateral comparisons can be seen confined dense shadow, breast gland margins Under the rule, another case of micro-calcified, partially visible mass shadow, fuzzy edge and multiple calcification points, different physiological cycles of the lesion shows an impact. Conclusions The majority of mammary glands with a large number of glandular types ≤35 years of age have poor contrast of X-ray images. The film is significantly affected by the menstrual cycle and the misdiagnosis rate is high. In addition to the typical X-ray signs of breast cancer, the atypical X-ray signs , Such as the limitations of dense film, thickening of the duct, increased blood vessel shadow, thickening, etc., need to be closely combined with clinical and other biopsy when necessary to improve the detection rate of the disease.