The Research Of Digital Mammography Sign Of Invasive Ductal Carcinoma And Invasive Lobular Carcinoma And Pathological Basis

Objective: To analysis digital mammography sign of invasive ductal carcinoma and invasive lobular carcinoma and to discuss the pathological basis;To improve both of the diagnostic accuracy and breast cancer's survival.Methods: The study included 254 histopathologically proven breast carcinoma patients in the Fourth Hospital of Hebei Medical University, including 178 cases of invasive ductal carcinoma and 76 cases of invasive lobular carcinoma. They were all female. The patients of invasive ductal carcinoma: the range of age was 26-77 years old,means age was 45 years old. And the patients of invasive lobular carcinoma: the range of age was 31-69 years old,means age was 48 years old.In the two groups, the age which had the highest incidence rates was 40-50 years old. The collection of imaging information: Image data collection: we used SIEMENS Movation DR for mammography and Barco5M vertical screen for image processing system. All patients took photographs for mediolateral oblique (MLO) view and cranio caudal (CC) view, parts adopted magnification mammography and galactography. Two experiential imaging directors diagnosed and brought forth diagnosis reports.The collections of pathology data: Collected surgery specimens and made in slice ups, Two experiential directors diagnosed . Then they brought forth diagnosis( including pathological grade).Form these data, we found the relationship between invasive ductal carcinoma's pathological grade and calcification,mass,or structural distortions and the relationship between the mass's edge and the types of invasive breast carcinoma. All results were caculated in a statistics software (SPSS Version 13.0), P<0.05 was considered to be ststistically signnificant.Results : 1 the main signs of invasive ductal carcinoma and invasive lobular carcinoma in the digital mammography To analysis digital mammography sign of 254 cases of breast cancer (178 cases with invasive ductal carcinoma, 76 cases with invasive lobular carcinoma).The major signs of invasive ductal carcinoma had simple mass,simple calcification, mass with calcification, small number expressed as structural distortions and asymmetric. And the major signs of invasive lobular carcinoma had structural distortion; asymmetric, and structural distortion or asymmetric with calcification, small numbers expressed as mass and calcification.The major signs were following: 1.1 The simple mass's signs were the space-occupying lesions could appear on the two positions. They inclulded 73 cases invasive ductal carcinoma(58 cases ofⅠ,Ⅱgrades, 15 cases ofⅢgrade).and 9 cases invasive lobular carcinoma. 1.1.1 The boundary of mass could be divided into well-defined, light-lobulated, fuzzy, invasion, as well as astral-shaped. In the invasive ductal carcinoma, well-defined (10 case), light-lobulated (3 cases), fuzzy (15 cases), invasion (23 cases), and astral-shaped (22 cases).And in the invasive lobular carcinoma, well-defined (1 case), light-lobulated (1 case), fuzzy (2 cases), invasion (3 cases), and astral-shaped (2 cases). 1.1.2 The predilection site of tumor was the outer upper quadrant, followed by the upper-inner quadrant and areola area. Among 178 cases of ductal carcinoma patients, 84 cases of upper-outer quadrant, 15 cases of lower-outer quadrant, 11 cases of lower-inner quadrant, 41 cases of upper-inner quadrant, and 27 cases of areola rear. Among the 76 cases of invasive lobular carcinoma, 32 cases of upper-outer quadrant, 7 cases of lower-outer quadrant, 5 cases of lower-inner quadrant, 19 cases of upper-inner quadrant, and 13 cases of areola rear. 1.2 The shape of calcification was varied, which could be scattered, and clusters-shape. Invasive ductal carcinoma were 24 cases, including 20 cases ofⅠ,Ⅱgrades, 4 cases ofⅢgrade. And invasive lobular carcinoma were 4 cases. 1.3 mass with calcification: Calcification could be simultaneous with the mass, also could be located with in the tumor, edge or around. The distribution was irregularity, to be together or scattered. Invasive ductal carcinoma were 46 cases, including 31 cases ofⅠ,Ⅱgrades, 15 cases of Ⅲgrade. And invasive lobular carcinoma were 6 cases. 1.4 structural distortion The mian signs included breast trabecular localized thickening, stiffness, the change of direction, or the high-density shadow and focal contraction came from a point of view radially, or the edge of parenchymal was distorted, but no specific mass. Invasive ductal carcinoma were 14 cases, including 14 cases ofⅠ,Ⅱgrades, 0 case ofⅢgrade. And invasive lobular carcinoma were 17 cases. 1.5 structural distortion with calcification: Invasive ductal carcinoma were 14 cases, including 13 cases ofⅠ,Ⅱgrades, 1 case ofⅢgrade. And invasive lobular carcinoma were 12 cases.1.6 asymmetric The X-ray findings didn't see the obvious for the mass, there was abnormal increasing density in the two breast projection position, or comparison of the both sides , they showed asymmetry. Invasive ductal carcinoma were 4 cases, including 2 cases ofⅠ,Ⅱgrades, 2 cases ofⅢgrade. And invasive lobular carcinoma were 21 cases. 1.7 asymmetric with calcification Invasive ductal carcinoma were 3 cases, including 3 cases ofⅠ,Ⅱgrades, 0 case ofⅢgrade. And invasive lobular carcinoma were 7 cases. 2 sign of galactography: In 254 cases,21 cases were checked-up by galactography because of nipple discharge. Contrast agents in ducts lost of continuum(6 cases); The ducts of mammary gland were pressed, distorted or intermitted(6 cases); The walls of ducts'were dissatisfied and lost smooth like worm's eroding(3 cases); The ducts'form was ankylosis and asymmetry(3 cases); Galactography had no visual mamary gland abnormal(3 cases).3 the relationship between invasive ductal carcinoma's pathological grade and calcification, mass,or structural distortions GradeⅢIDC was more likely to be associated with a mass when findings were seen on mammogram. (χ2 =4.267,P=0.039), and grade I and gradeⅡIDC were more likely to be associated with distortion (χ2 =5.980,P=0.014). But the pathological grade had no relationship with calcification(χ2 =0.501, P=0.479)and asymmetric(χ2 =0.268, P=0.636) 4 the relationship between the edge of mass and the types of invasive breast carcinoma Form both of them mass's edge, the invasive ductal carcinoma's every circumstances seemed to common. However, obtained by statistical analysis, it was no statistical significance(χ2=2.326,P=0.783>0.05). It was no relationship between the simple mass's edge and the types of invasive breast carcinoma.Conclusion: The major signs of invasive ductal carcinoma had simple mass; simple calcification; mass with calcification, small number of the performance of structural distortion and asymmetric. And the major signs of invasive lobular carcinoma had structural distortion; asymmetric;, and structural distortion or asymmetric with calcification, small numbers expressed as mass and calcification. GradeⅢIDC was more likely to be associated with a mass when findings were seen on mammogram, and grade I and gradeⅡIDC were more likely to be associated with distortion. But the pathological grade had no relationship with calcification and asymmetric. It was no relationship between the simple mass's edge and the types of invasive breast carcinoma.