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目的总结乳腺癌超声检查漏诊因素,分析漏诊原因以提高超声对乳腺癌的检出率。方法回顾分析超声检查出乳腺癌并经穿刺或手术病理证实的病例44例46个病灶,所有病例之前3个月内曾在我院或外院行乳腺超声检查,报告中均未提及该病灶。结果 44例病例中15例为多发恶性病灶,22例合并良性病灶,29例腋窝淋巴结阳性;46个病灶超声下长径在0.6~9 cm之间,浸润性癌40个,原位癌6个;可见经钼靶证实的微钙化14个。结论超声漏诊乳腺癌的原因与病灶的声像图表现有关,尤其是较大的病灶;与多发性病灶有关;还与操作者技术和经验有关。在乳腺超声检查中,如果有微钙化或腋窝淋巴结呈阳性表现,应当引起注意;另外,还应当注重病史及其他影像检查结果。
Objective To summarize the causes of missed diagnosis of breast cancer and analyze the causes of missed diagnosis to improve the detection rate of breast cancer by ultrasound. Methods A retrospective analysis of 44 cases of 46 lesions confirmed by ultrasonography in breast cancer with puncture or surgical pathology was performed. Ultrasound examination of breast was conducted in our hospital or outside hospital in the previous 3 months. All the reports did not mention this lesion. Results Of the 44 cases, 15 were multiple malignant lesions, 22 were associated with benign lesions and 29 were axillary lymph nodes. The major diameter of 46 lesions was between 0.6 and 9 cm under ultrasound, 40 were invasive and 6 were carcinoma in situ ; Visible by the molybdenum target confirmed microcalcification 14. Conclusion The causes of missed diagnosis of breast cancer by ultrasonography are related to the sonographic manifestation of the lesion, especially the larger lesion; it is related to multiple lesions; and it is also related to the operator’s technique and experience. At breast sonography, attention should be given to the presence of microcalcifications or axillary lymph nodes; in addition, medical history and other imaging findings should be emphasized.