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目的:探讨常见乳腺癌的X线表现与其病理基础,分析误诊原因,以提高乳腺癌X线诊断水平。方法:回顾性分析经数字化X线检查并手术病理证实的乳腺癌105例,107个病灶,观察乳腺癌的常见X线征象,并与病理类型相对照。结果:①浸润性导管癌75个,导管内癌及导管内癌伴微浸润12个,浸润性小叶癌7个,髓样癌8个,黏液腺癌5个;②X线征象有肿块者68个(63.6%),有钙化者52个(48.6%),局灶性致密影11个(10.3%),结构扭曲者6个(5.6%);③本组误诊10例,误诊率9.5%。结论:浸润性导管癌X线表现多样,导管内癌最常见X线表现是单纯钙化,对临床未触及肿块的单纯钙化首先要考虑导管内癌,其余征象均首先考虑浸润性导管癌。重视局灶性致密影和结构扭曲可减少误诊。
Objective: To investigate the X-ray findings and pathology of common breast cancer and to analyze the causes of misdiagnosis so as to improve the X-ray diagnosis of breast cancer. Methods: 105 cases of breast cancer confirmed by digital X-ray and surgically pathologically confirmed, 107 lesions were observed retrospectively. The common X-ray signs of breast cancer were observed and compared with the pathological types. RESULTS: ① There were 75 invasive ductal carcinomas, 12 intraductal carcinomas and intraductal carcinomas with microinvasion, 7 infiltrating lobular carcinomas, 8 medullary carcinomas and 5 mucinous adenocarcinomas. There were 68 (63.6%), 52 (48.6%) had calcification, 11 (10.3%) had focal dense shadow and 6 (5.6%) had structural distortions; (3) 10 patients were misdiagnosed with a misdiagnosis rate of 9.5%. CONCLUSIONS: Infiltrating ductal carcinoma has many X-ray manifestations. The most common X-ray findings of intraductal carcinoma are simple calcifications. For the simple calcification of untreated tumors, the intraductal carcinoma should be considered firstly, and the remaining signs should be considered for invasive ductal carcinoma first. Focus on focal dense shadow and structural distortion can reduce misdiagnosis.