Clinical Analysis On Breast X-ray Photography Of False-negative Breast Cancer

Background and Objective:Breast cancer is common malignancy of women,and the global incidence has been the first accounts of women'scancer.The survival of breast cancer for women, both physically and mentally causing great damage.There are several methods of breast cancer diagnosis, however, examination of breast X-ray photography of early breast cancer detection is still a basic, the most effective screening method. Chinese Anti-Cancer Association and regulation of breast cancer treatment guidelines (2008) pointed out that breast cancer screening to include breast X-rays examination, but the shortcomings of the breast X-ray photography include poor development for the dense glands, lesion images easily concealed, the problem of false-negative, and so on.Although few such cases , but for the clinical diagnosis of breast cancer is important. This article aims to review, analyze the differences between true positive and false negative of breast X-ray photography, to summarizes the common features of such cases, and provide information for clinical diagnosis and treatment of breast cancer to doctors.Materials and methods:Select 343 general surgery patients with breast cancer between 2009.6.1 and 2010.12.31 in First Affiliated Hospital of Dalian Medical University, all with preoperative examination of breast X-ray photography, not put chemotherapy, breast cancer patients were confirmed by pathology. 29 of these patients are false negative, 8.45% of the total. Comparing the age, menopause, first symptom, course of disease, mammary gland, lesion site, lesion size, pathology, lymph node metastasis and immunohistochemistry. et among those which are true positive breast X-ray photography (314cases) same period to retrospective analysis the relationship to breast cancer detection by X-ray photography. To identifying the breast X-ray photography produce false-negative factors, and can help clinical diagnosis and treatment of breast cancer. Results:Of the false negative group, most are young middle-aged patients, Compared with the true positive group, there are differences between the two, P=0.041; False-negative group of smaller diameter tumors, the percentage of Tis, T1patients account for 6.9%(2/29),79.3%(23/29), much higher than the true positive group 1.6%(5/314),40.8%(128/314); False-negative group clinical stage of tumor are 0 and stageâ… , account for 6.7% and 93.3%,much higher than the true positive group 1.0% and 26.4%. The percent of tumor located in the areola area, the inferior quadrant, the upper quadrant, near the ratio of chest area in false negative group higher than the true positive group, especially in the highest proportion of tumors in the areola, there was significant difference between the two, P=0.000; The percent of gland-type large amounts in false negative group (79.3%) much higher than the true positive group (45.2%), the compact-type glands in the false negative group are not statisticed, and can not be compared with the true positive ones.There's no statistically significance between the two groups through comparing the age , menopause , first symptom , course of disease , mammary gland , lesion site , lesion size , pathology , lymph node metastasis and immunohistochemistry relationship to breast cancer detection by X-ray photography false negative , either P> 0.05. In a multivariate analysis, tumor size, location and the gland are to produce false-negative breast X-ray photography of factors, The tumor location, gland under the same conditions,the smaller the tumor is , the higher the false negative rate will be ; in tumor size , gland under the same conditions, tumors which the more close to the areola area , the higher false negative rate will be , the remaining all P>0.05 , and there is no statistically significance ; in tumor size , location under the same conditions , gland all P>0.05 , and there is no statistically significance either.Conclusion:Of 343 routine breast X-rays examination of breast cancer patients were analyzed retrospectively , and get the following results : Univariate analysis show :1.Young , middle age is more likely than older patients show false negative X-ray photography2.Small diameter of tumor prone to false negative X-ray photography3.Clinical stage as early as prone to false-negative X-ray photography4.Tumor those which are locat in the areola area, the inferior quadrant , the upper quadrant, near the ratio of chest area prone to false-negative X-ray photography .5.Mammary gland density prone to false-negative X-ray photography. 6.There is no significant difference btween course of disease, menopause , first symptom, lymph node metastasis , pathology , molecular type , immunohistochemistry and false-negative breast X-ray photography .Multivariate regression analysis show that: Tumor size , location and the gland is to produce false-negative breast X-ray photography of factors. The tumor location, gland under the same conditions,the smaller the tumors are , the higher the false negative rate will be; in tumor size, gland under the same conditions, tumors which the more close to the areola area, the false negative rate higher will be.