| Objective:To analyze the mammographic features of nonpalpable breast lesions and the correlation between the mammographic and pathologic findings. Try to provide clinical criteria for selecting appropriate treatment.Methods:A retrospective study of 92 patients with nonpalpable breast lesion(NPBL) between November 2009 and December 2010 was performed. Each patient has been performed three-dimensional stereotactic wire localization biopsy before operation to obtain pathologic results. Radiographic result was made according to Breast imaging reporting and data system(BI-RADS),which was developed by American College of Radiology. Mamographic features were divided into microcalcification,mass and architectural distortion. Analyze the correlation between mammograohic features and pathologic results.χ2 test was used to detect difference between malignant and benign radiographic signs. The correlation between morphology and distribution of microcalcification and pathology was test using Kappa analysis. Analyze the correlation between morphologic characteristic of mass and architectural distortion and pathologic results.Results:①the Mammographic signs of nonpalpale breast lesion mostly represent microcalcification, 71.7% ( 66/92 ) ,followed by mass and architectural distortion.②Malignant and benign radiographic signs are different, with statistical significance(P<0.005).③Microcalcification of benign lesions usually manifest puctate and round.microcalcification of malignant lesions mainly represent crushed stone.both of its distribution is cluster. Combining morphology and distribution of microcalcification to analyze pathologic results, sensitivity and specificity is 92.3%,94.3%,K value is 0.819.④Pathologic of mass is mainly benign, benign masses are regular,distinct or obscure with isodensity, malignant mass are spicular masses with high desinty.⑤Pathologic of architectural distortion is mainly benign, with central lucent.However malignant is of"white"central.Conclusion:①Microcalcification is an important mammographic feature of nonpalpable breast lesion,by which Mammography can detect disease at the early stage. And then conservative therapy is possible.②Regional distribution is classified as benign,cluster and segmental distribution is classified as intermediate type,and linear distribution is classified as malignant. Punctiform is classified as benign,powder like is classified as intermediate type,and crushed stone and linear like are classified as malignant. Combined distribution and morphology of microcalcification to analyse pathology is of high consistent.③Pay special attention to mass with high density and architectural with"white"central. Purpose:To determine the indication of x-ray guided breast biopsy for nonpalpable breast lesion.Meterials and Methods:A retrospective study of 92 patients with nonpalpable breast lesion detected by mammography, Each patient has been performed three-dimensional stereotactic wire localization biopsy before operation to obtain pathologic results. These patients were divided into five groups according to age, as follows: younger than 30 years old, 30-39,40-49,50-59,older than 60 years old. Analysis positive predictive value of each group. Radiographic results were made by two experimenced radiologists according to Breast Imaging Repoting and Data System, which was developed by American College of Radiology. Radiographic Results are as follows: BI-RADS 2, 3, 4A, 4B, 4C, and 5. BI-RADS 2 is ususlly benign and with no special treatment. BI-RADS 3 is usually treated by regular folloe up, and during this period, if any radiographic signs happened, breast biopsy is adviced. BI-RADS 4 and 5 are usually adviced biopsy immediately. Mamographic features were divided into microcalcification,mass and architectural distortion.χ2 test was used to detect difference between PPV of each BI-RADS group.Results:①the PPV of each age group is 0%,12.5%,15.4%,18.2%,40.0%, PPV increase by age.②According to BI-RADS ,the lesion was defined as BI-RADS 3,4or5,and most of them are BI-RADS 4,89.3%(75/84),followed by BI-RADS 3, 7.6%(7/92)BI-RADS 5,6.5%(6/92)③PPV of BI-RADS 3,4,5 is 0%,12.9%,100% separately.Positive predictive value of BI-RADS 4C and 5 are different from BI-RADS 4A,4B and 3,and BI-RADS 4C is higer than BI-RADS 4B and 4A.Conclusion:Mammography can detect disease at the early stage and BI-RADS may provide advice for clinical to select appropriate treatment. In order to increase clinical cost effect, make a breast biopsy advice.,comprehensive consideration of age, mammographic signs and clinical symptoms... |
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