| Objective: To assess the value of high frequency ultrasound combined with mammography in the diagnosis of early breast cancer.Methods: Sixty five female patients who were suspect of early breast cancer were examined by the high frequency ultrasound as well as mammography ,and confirmed by stab biopsy or operation pathological examination. Ultrasoud examination used PHILIP HDI5000 which used linear array high frequency probe ,and the frequency of probe was 12 MHz.X-ray machine was GE digital plate molybdenum target mammary machine which used high definitional tachy-collection work station and high resolution display's browsing station.Mammagraphy examination used CC position and MLO position, added lateral position and zoom photogragh if it is necessary. The patients adopt supine position and right or left arm recumbent in ultrasound examination. To check minutely each quadrant of the bilateral breast with length wise ,transversal, and radial investigation.The diagonostic criteria of mammography is as follows : barb or sublobe appearance's tumor, having no distinct boundary, focal structure being disorder,or having typical clustering microcalciffcationoThe diagnostic criteria of high frequency ultrosoud is as follows: the shape of the tumor being irregular , having no distinct boundary and intact amicula ,the internal echo being uneven and the bulk being hypo-echo ,the quadrate echo of the tumor being attenuated, the length and breadth ratio of the tumor exceeding 1, the blood flow of the tumor surpassing Grade II according to Alders' grading , PSV>20cm/s, and RI>0.7.The diagnostic criteria of the two methods combined examination is as follows: 1 The tumor being innocent if the two methods all discover definite innocent sign . 2 The tumor being malignant if anyone method can find pernicious sign. 3 If the mammography can't determine the nature of the tumor ,the diagnostic result refer to the high frequency ultrosoud examination .Handling the data with the statistical method.Results:Through the examination on 65 patients, high frequency ultrosoud find that 40 patients were malignant and 25 patients were innocent, the mammography find that 29 patients were malignant and 36 patients were innocent,or the pathology examination find that 47 patients were malignant and 18 patients were innocent.The sensitivity , specificity , accuracy , positive predictive value , negative predictive value and false positivity rate , false negativity rate of high frequency ultrasound and mammography were 66.0%, 44.4%, 60.0%, 75.6%, 33.3%, 55.6%, 34.0%and 44.7%, 77.8%, 53.8%, 84.0%, 35.0%, 22.2%, 55.3% respectively. There was significant difference between the two methods. The sensitivity , specificity , accuracy , positive predictive value , negative predictive value of the combined two methods could reach 85.1%,83.3%,84.6%,93.0%, 68.2%, which were significantly higher than that of the only one method, while the false positivity rate and the false negativity decreased to 14.9% and 16.7%, which were significant decreased .Conclusion:With regard to the diagnosis of the early breast cancer,the high frequency ultrasound examination was superior to the mammography ,the combined two methods was superior to any one method . And the combined two methods can increase the diagnostic sensitivity and accuracy of early breast cancer , and has the significant value of clinical application. |
