乳腺内微钙化X线征象再认识

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目的探讨微钙化对乳腺癌诊断的价值。方法收集钼靶X线片表现有微钙化的乳腺病变共120例,均经病理证实,其中乳腺癌97例(浸润性导管癌71例,浸润性小叶癌23例,黏液癌2例,髓样癌1例)及良性病变23例(乳腺增生13例,慢性炎症4例,脂肪坏死3例,增生伴脂肪坏死3例),所有病例均行钼靶X线摄影,并对照分析其钼靶X线表现。结果(1)120例乳腺病变微钙化按密度分为高、中、低3类,分别占37.50%(45/120)、28.33%(34/120)和34.16%(41/120),其中高密度钙化多见于良性病变,占82.00%(19/23),中、低密度微钙化恶性多见,占73.19%(71/97)。(2)恶性微钙化直径多<0.5mm,表现为泥沙样、沙砾状68例,粗大钙化18例,“Y”、“V”、“树枝”形或粗棒铸型钙化8例,蠕虫样钙化3例。良性微钙化的直径一般>0.5mm,形态规则,边缘清楚。(3)大片密集或成簇的微钙化恶性多见,占84.53%(82/97),散在稀疏或粗大微钙化良性多见,占69.56%(16/23)。结论微钙化在乳腺癌诊断中,特别是早期癌诊断中具有重要价值,应重视与良性微钙化的鉴别诊断。 Objective To investigate the value of microcalcification in the diagnosis of breast cancer. Methods A total of 120 cases of breast lesions with microcalcifications were collected from mammograms. All of them were confirmed by pathology, including 97 cases of breast cancer (71 cases of invasive ductal carcinoma, 23 cases of invasive lobular carcinoma, 2 cases of mucinous carcinoma, 1 in breast cancer and 23 in benign lesions (13 cases of hyperplasia of breast, 4 cases of chronic inflammation, 3 cases of fat necrosis and 3 cases of hyperplasia with fat necrosis). All patients underwent mammography, Line performance. Results (1) 120 cases of breast lesions were divided into high, medium and low micro-calcifications according to their density, accounting for 37.50% (45/120), 28.33% (34/120) and 34.16% (41/120) Densified calculi more common in benign lesions, accounting for 82.00% (19/23), medium and low density micro-calcification malignant more common, accounting for 73.19% (71/97). (2) The diameter of malignant microcalcifications was less than 0.5mm, which was characterized by sediment-like, gravel 68, coarse calcification 18, calcification of “Y”, “V”, " Like calcification in 3 cases. The diameter of benign micro-calcifications is generally> 0.5mm, regular shape, clear edge. (3) Massive or clustered micro-calcifications were more common, accounting for 84.53% (82/97). Sparse or coarse micro-calcifications were more common in 69.56% (16/23) patients. Conclusion Microcalcifications have important value in the diagnosis of breast cancer, especially in the diagnosis of early-stage cancer. Differential diagnosis with benign micro-calcification should be emphasized.
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