| Objective: Breast cancer(BC) is one of the most common malignant tumors of women. In recent years, with the increasing incidence of the disease, So far the causes are unknown,which is impossible for people to advance prevention. The research results show that the treatment sooner or later of breast cancer is closely related to and the time of patients survival. So people begin to pay more and more attention to early screening and early treatment. The purpose of this study was to investigate the value of ultrasound and its guided biopsy in the diagnosis and differential diagnosis of small breast masses, and analysize the correlation between the ultrasound features and molecular markers, estrogen receptor(ER), progesterone receptor(PR), human epidermal growth factor receptor 2(c-er Bb-2,HER-2) in small breast cancer.Methods:(1) A total of 145 cases of small breast mass with diameter less than or equal to 2 cm were selected from Tianjin Fifth Central Hospital during 2011-2013. All the cases were divided into two groups by the lesions, 56 cases in benign group, which were cut or followed up.89 cases in suspected malignant group, which were guided by ultrasound guided biopsy or intraoperative frozen biops. Ultrasound results were compared with pathology or follow-up results. Calculate the coincidence rate of ultrasound diagnosis in each group, respectively. Statistic analysize the accuracy and specificity of ultrasound guided biopsy and frozen section diagnosis, respectively. and compare the differences between the two.(2)120 cases of breast cancer diagnosed by pathology with diameter less than or equal to 2cm were selected from Tianjin Fifth Central Hospital during January 2009 to December 2014.Ultrasound image features of each case was retrospectively observed, and then the diagnostic significance of each sign is analyzed in small breast cancer. All cases were treated by surgical operation, and were performed by pathological examination and immunohistochemical staining. Then we analyzed the correlation between the ultrasound signs and the expression of ER, PR and c-er Bb-2 in small breast cancer.Results:(1) In the diagnosis of small breast tumors, the coincidence rate of ultrasonography for benign lesions diagnostic was 96.4%(54/56), and which for suspicious malignant lesions was 47.2%( 42/89).The diagnostic accuracy of ultrasound guided biopsy and intraoperative rapid frozen biopsy was 94.2% and 94.6%, respectively, the positive sensitivity of which was 96.4% and 94.1% respectively,and The specificity of which was 92.3% and 95.2% respectively. There was no significant difference between the two methods(P>0.05).(2) Occurrence rate of small breast carcinoma ultrasonographic features: no capsule was 100%, spiculate margin accounted for 43.3%, tumor echo attenuation rate accounted for 37.5% and aspect ratio ≥ 1 accounted for 36.7%, micro calcification rate accounted for 40%, blood flow grade I-II and III- IV accounted for 70.8% and 29.2%,respectively.The diagnostic accuracy rate of ultrasonography has significant differences in having or no burr syndrome, different aspect ratio and with or no micro calcification group(P<0.05). There was no significant difference in the diagnostic accuracy of ultrasound between the two groups with or no echo attenuation and different blood flow(P>0.05). Micro calcification has positively correlated with the expression of c-er Bb-2(P<0.05). There was no significant difference in the expression of ER, PR and c-er Bb-2 between the two groups with or no burr sign, different aspect ratio, with or no echo attenuation and different blood flow(P>0.05).Conclusion:(1) Ultrasonic inspection for early breast lumps is a simple, safe and effective method, which plays an important role in the diagnosis and differential diagnosis of small breast masses. Ultrasound guided percutaneous biopsy in diagnosis of small breast tumors is safe, reliable preoperative diagnosis method. For special cases, it should be combined with the quick frozen biopsy or cutting inspection.(2) Ultrasonographic features including capsule, edges, aspect ratio and micro calcification is an important reference index for the Ultrasonic diagnosis of small breast cancer. Comprehensive consideration of various indicators helps to improve the diagnostic rate of small breast cancer. The biological characteristics of tumor is the basis of the ultrasound performance of breast cancer. The appearance of micro calcification can help to predict the expression of c-er Bb-2, which also can help for the prognosis evaluation of small breast cancer and the choice of clinical treatment methods. |
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