| Objective:Aim of the study is to evaluate the value of methods using Color Doppler Ultrasound,Molybdenum Target X ray and combined application in differential diagnosis of breast masses ,and access the value of ultrasound in the diagnosis of axillary lymph node metastasis in breast cancer patients.Methods and materials:110 patients and axillary lymph node metastasis in 30 patients with breast cancers were studied and compared with pathological results. All 110 patients were examined by both Color Doppler Ultrasound and Molybdenum Target X ray independently,Results:1. There are 46 cases of benign lesions were 22 fibroadenomas, 5 hyperplasia, 6 sclerosing adenosis, 4 galactocele , 2 plasma cell mastitis , 2 ductal ectasia , 2 inflammatory lesions, 1 lobular adenomatoid, 1 papilloadenocystomas, 1 cystosarcoma phylloides(benign); There are 64 cases of malignant lesions were 43 invasive ductal carcinomas , 12 invasive lobular carcinomas, 4 mucinous adenocarcinoma, 2 ductal carcinomas in situ,2 adenoid cystic carcinoma of breast, 1 lipid-rich carcinoma of breast.2. The detection rates of vessels in benign and malignant were 58.7%(27/46), 89.1%(57/64), respectively. This was statistically significant (P<0.001).3. The diagnostic accuracy of ultrasonography was 83.6℅ (92/110), which was higher than that of molybdenum target X ray 75.5℅ ( 83/110 ) ,compared with pathological results.There was no apparent difference between them(P>0.05). But, Combined Color Doppler Ultrasound and Molybdenum Target X ray have a higher accuracy.4. In 110 women, 64 cancers were found ,sensitivity, speciality, false positive rate , false negtive rate, positive and negative predictive values,and accuracy of US were 87.5%,78.3%,21.7%,12.5%,84.8%,81.9%,83.6%,respectively;and those of mammography, 75%, 76.1%, 23.9%, 25%, 81.4%,68.6%,75.5%,respectively; and those of mammography- ultrasound combination,98.4%,91.3%,8.7%,1.6%,94.0%, 97.7%,95.5%, respectively. While false positive rate(8.7%) and false negtive rate(1.6%) decreased,and sensitivity(98.4%) speciality(91.3%) increased.5. Compared with pathological, in≤2cm group, combined Color Doppler Ultrasound and Molybdenum Target X ray had higher sensitivity and accuracy rate than using either single modality,and there was no significant difference in accuracy rate between Color Doppler ultrasoung and Molybdenum Target X ray ;But, in >2cm group ,there was no significant difference in accuracy rate between ultrasound and mammography-ultrasound combination., and combined Color Doppler Ultrasound and Molybdenum Target X ray had higher sensitivity and accuracy than using Molybdenum Target X ray alone.6. According to this study Color Doppler Ultrasound showed an efficiency of 49.1% compared to 37.3% for Molybdenum Target X ray in detecting microcalcification, indicating no significant difference between Color Doppler Ultrasound and Molybdenum Target X ray(P>0.05), both them are all the important tools for the diagnosis of breast microcalcification. However, Color Doppler Ultrasound had an efficiency of 48.4% and Molybdenum Target X ray 25 % in detecting microlobulation, the statistical results disclosed significant statistics meaning between them(P<0.05).7. The positive rate of axillary lymph node metastasis of 64case was 46.9%(30/64) ,and the accuracy rate of Color Doppler Ultrasound was 73.3%(22/30),but the accuracy rate of axillary lymph node metastasis by Molybdenum Target X ray was 43.3%(13/30).The accuracy rate of axillary lymph node metastasis by Color Doppler Ultrasound was significantly greater than that by Molybdenum Target X ray(P<0.05).Conclusions:1. Combined Color Doppler Ultrasound and Molybdenum Target X ray had well fit to pathological.2. Compared with pathological,combined two methods had higher sensitivity and accuracy rate than using either single modality in≤2cm group ; But, in > 2cm group ,there was no significant difference in accuracy rate between ultrasound and mammography-ultrasound combination.3. By analyzing the feature of gray-scale sonography,color and power Doppler and evaluating vascularity of breast neoplasms,Ultrasonography can provide the value reference for differentiate breast lesions.4. Color Doppler Ultrasound showed the character of axillary lymph node metastasis in breast cancer patients: irregular sharp, to mix together ,aboundant vascularity,et al. Color Doppler Ultrasound has greater value clinically ideal for the detection of whether metastatic involvement is present or not. |
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