The Comparative Study Of The X-ray Manifestations And Clinical Pathology Of The Breast Architectural Distortion

Objective: To discuss full-field digital mammography in benign and malignant architectural distortion of X-ray features and clinical pathological features,deepen the understanding of the X-ray imaging features,to improve the diagnostic rate of breast malignant disease,which is mainly manifested by the architectural distortion.Methods: A total of 32 cases of structural distortion were collected in full-field digital mammography and eliminate those confirmed by position or pressure factors caused breast density anomaly and with typical malignant calcification,showed only for breast architectural distortion,of which all have pathological results.The clinical pathological features and imaging features of the patients were analyzed retrospectively and the similarities and differences of the molybdenum target X-ray images of structural distortion were summarized and analyzed,2 cases of gross specimens and pathological sections were compared and analyzed.Results:1 The age of onset was 25-67 years old,with an average age of 49.3years.Among them there were right breast in 15 cases(15/32),17 cases of left breast(17/32).Statistical analysis of all ages of incidence and prevalence of left and right sides were of no statistical difference.2 this group of structural distortion of the X-ray signs is characterized by spiculations radiating from a point.3 8 cases of benign lesions,including 1 case of sclerosing adenosis,radioactive adenosis with atypical epithelial hyperplasia in 2 cases,adenosis with ductal epithelial hyperplasia of usual type in 3cases,postoperative change in 2 cases;malignant lesions in 24 patients,the infiltrating lobular carcinoma in 4 cases,20 cases of infiltrating ductal carcinoma.4 there were 4 cases of architectural distortion in the patients with calcification,the calcification distribution of the main manifestations were scattered or cluster.Calcification is located at the center of the lesion or the edge of the burr,Postoperative pathology are all malignant,It is suggested that the malignant probability increases when the structure is twisted with calcified.5 The morphology and the volume of the affected gland of the benign can be changed with the change of the film position,while the morphology of the malignant is relatively fixed.in this group,13 cases were changed,8 cases were benign and 5 cases were malignant;19 cases are relatively fixed,all cases were malignant.6 The central density of architectural distortion is related to benign and malignant lesions,Central hyper-density is more prone to malignant lesions,and Central hypo-density is more prone to benign lesions,there were statistical differences between them(P<0.001).in this group,19 cases with Central hyper-density were all malignant;7 cases with iso-density,4 cases were benign and 3cases were malignant;6 cases with the typical "black nuclear sign" or hypo-density,4 cases were benign and 2 cases were malignant.7 The morphology of burr is correlated with the benign and malignant lesions:burrs of thick short,stiff are prone to malignant lesions,and burrs of slender and soft are prone to benign lesions,there were statistical differences between them.in this group,7 cases with burr of soft and slender,of which 1 case with burr of disorderly,they are all benign;17 cases with burr of stiff and thick long,1 case with burr of soft and thick long,are all malignant;3 cases with burr of stiff and short thin are all malignant;4 cases with burr of varying lengths,thick,stiff,1 case was benign and 3 cases were malignant.8 Benign architectural distortion in the center of the lesion without lumps or micronucleus and malignant architectural distortion although mass is not obvious,but most still found the lesion center has a small micronucleus around radial distribution of varying lengths burr,may be the initial stage of tumor formation.9 The architectural distortion of benign and malignant were observed under the microscope: the burr of benign is mainly composed of elastic fiber tissue;the burr of malignant:burr root is constituted by the number of tumor cells and a small amount of inflammatory cells and fibrous tissue and middle burr is mainly constituted by fibrous tissue and tumor cell reduction and visible a few inflammatory cells infiltration,the tip of burr showed a large amount of fibrous tissue and a small amount of inflammatory cells,tumor cells disappeared.Conclusion:1 There was no significant difference in the prevalence of breast architectural distortion between the age of onset and the incidence of left and right breast.2 The morphology and the volume of the affected gland is easy to change,the burr is more slender and soft,and the length is more uniform,no mass in the center of the lesion,These signs are more prone to benign lesions;The morphology and the volume of the affected gland is relatively fixed,the burr is more thick short or varying lengths,uneven thickness and even as thick tapering,stiffness,in the center of the lesion there is a small micronucleus,These signs are more prone to malignant lesions.3 The radial long burr of the benign and malignant architectural distortion is mainly composed of fibrous tissue.4 Architectural distortion is one of the main signs of early breast cancer.5 For those with calcification,the possibility of malignancy increases.