The Diagnosis Value Of Digital Mammography For Breast Fat Necrosis

Objectives: To evaluate the X-ray appearance of fat necrosis in the breast, and correlates the imaging findings with the pathologic findings.Analyze the cause of misdiagnosed breast cancer and decrease the probability of misdiagnosis, in order to improve the diagnostic level and provide evidences for clinical diagnosis and avoid unnecessary surgery.Materials and methods: 1. Object of study:The X-ray films of 33 cases of fat necrosis which were confirmed by the histologic findings were respectively analyzed in the Fouth Hospital of Hebei Medical University(2008.3-2009.12). All patients were female with the median age of 43 years (range 27-77). All patients went to see the doctor because of breast mass,including 23 cases of indolent masses,2 cases of tenderness,5 cases of traumatic history. The texture of most masses was hard, ill-defined border. Most of the lesions didn't have conglutination with skin. 10 cases were Clinical misdiagnosed,including breast cancer, hyperplasia of mammary glands, mastitis,and so on.2. Equipment and methods:They were all examined by SIEMENS full-field digital mammography. Craniocaudal (CC) view and mediolateral oblique (MLO) view conducted for every patient. CV view was achieved if it is necessary. 3. Statistical method:Carries on the data analysis using the SPSS13.0 statistics software, uses the chi-square test, examination standard a=0.05, p<0.05 is the difference has statistics significance.Results:1 There were 33 cases, including 18 cases of tubercle or lump including 72.2% (13/18) was in upper outer quadrant,21 cases of ill-defined (63.6%) including 76%(16/21) was in upper outer quadrant, 23 cases of hard masses (69.7%) including 2 cases of tenderness, 8 cases of related cause of disease including 5 cases of explicit disease including 5 cases of explicit trauma,1 case because of surgery.2 There were 33 cases including 10 cases( 30.3%) of clinical misdiagnosis including,5 cases of misdiagnoses breast cancer,1 case of hyperplasia of mammary glands,1 case of fibro-adenoma,1 case of adenopathy nodule,1 case of mastitis,1 case of mammary gland adenopathy.3 (1) X-ray appearance of 7 cases was lipid-cyst,including 5 cases with linear and curvilinear calcifications,1 caes with coarse calcifications,2 cases with architectural distortion; (2) X-ray appearance of 5 cases was focal architectural distortion,including 1 case with calcifications ,2 cases with pachyderma,1 case with subcutaneous fat turbid ;(3) X-ray appearance of 10 cases was high density speculate mass, including 4 cases with calcifications, 1 case with pachyderma, 1 case with coarse calcifications; 2 cases with microcalcifications; X-ray appearance of 7 cases was normal .4 Fat necrosis is divided into the intraglandular and the extraglandular on the mammography. 17 cases of which was intraglandular ,ingcluding 8 cases were diagnosed fat necrosis. 9 cases of which was extraglandular, ingcluding 8 cases were diagnosed fat necrosis. 7 cases was normal. The intraglandular and the extraglandular accurate rate is 47% and 88.89% respectively. The number of the group was 33(n<40) and one theory frequency T <5, therefore, four table materials was suitable for the Fisher accurate probability.P=0.087, P>0.05, non-statistics significance.5 There were 33 cases. 7 cases of which belongde toâ…¡type,including 3 cases(42.9%) of correct diagnosis.6 cases of which belonged toâ…¢type ,including 3 cases(50%) of correct diagnosis.20 cases of which belonged toâ…£type,including 9 cases(45%) of correct diagnosis. All the cases are divided into 6 type according to the BI-RADS classification. 7 cases belonged to 1 type; 20 cases belonged to 2 type including 15 cases of diagnosis correct; 2 cases belonged to 3 type; 2 cases belonged to 4 type; 1 case belonged to 5 type.6 2 cases were examed by Ultrasound too. Ultrasound appearance of 1 case was echo-level mass with posterior acoustic shadowing. Ultrasound appearance of another case with explicit trauma was dense echo mass. Their X-ray appearance was normal .Conclusions:1 Most of the fat necrosis of breast manifests tubercle or lump in upper outer quadrant.2 The fat necrosis of breast is easy to misdiagnosed breast cancer in mammography mostly.3 Because the X-ray manifestation fat necrosis of breast is consonance with inflammatory repair, so X-ray appearance of fat necrosis of breast is manifold. It is most commonly manifested as nodules or mass.4 We can't think that it isn't different about accurate rate of fat necrosis intraglandular and the extraglandular on the mammography.5 We can't think that it isn't different about accurate rate of fat necrosis mammary gland classification...