Analysis Of Factors Influencing The Detection Of Meaningful Biopsy Lesions In Breast Masses With Diameter?1.0cm

Objective:At present,domestic and foreign experts have not reached a consensus on the treatments of small nonpalpable lesions(?1.0cm)clinically.And for Asia's young and middle-aged women with the characteristics of a relatively small and dense breast,sensitivity of breast mammography is low,and sensitivity of breast color ultrasound judging the feature of lesions whose diameter are 1.0 cm or less is relatively low.This study intends to carry out a retrospective study on lesions with diameter?1.0cm,explore the relevant influencing factors for the detection of significant lesions and further summarize the appropriate treatments for such lesionsMethods:From the data collected by dong yi et al.,231 patients with surgical pathology were selected from the 1137 female patients admitted to the department of breast surgery outpatient or inpatient of first Bethune hospital in jilin university from 2009-01-01 to 2010-12-31.The pathological findings of precancerous lesions or fibroadenomas were determined as significant lesions Univariate and multivariate analysis were performed on the influencing factors of the detection of significant lesions.Logistic regression analysis was further performed for the detection of significant lesions and ROC curve was established to evaluate the accuracy of diagnosis through sensitivity,specificity,Jordan index and AUC.Results:In present study,Univariate analysis showed that smoking history(?~2=9.002,p=0.003)and boundary(?~2=7.618,p=0.006)were the risk factors influencing the detection of significant lesions.Multivariate analysis showed that smoking(OR=3.397,95%CI:1.018-5.648,P=0.001)and boundary(OR=2.260,95%Cl:1.431-4.752,P=0.002)were independent risk factors for predicting the detection of significant lesions.The AUC of smoking diagnosis was 0.563(95%CI:0.497-0.828).The AUC of borderline diagnosis was 0.583(95%ei was 0.516-0.647).The AUC of smoking combined with boundary was 0.640(95%CI:0.574-0.702).The AUC of boundary and boundary combined with smoking was statistically significant(Z=2.298,P<0.05).There was a statistically significant difference in AUC between smoking and boundary combined smoking(Z=3.020,P<0.05).The sensitivity,specificity and youden index for diagnosis of meaningful lesions were 37.61%,78.38%and 0.159,respectively.The sensitivity,specificity and youden index of significant lesions diagnosed with smoking history alone were 27.95%,84.74%and 0.126,respectively.The sensitivity,specificity and youden index were 52.14%,73.68%and 0.257,respectively.Among them,the sensitivity of significant lesions diagnosed by smoking combined with boundary was higher than that diagnosed by smoking history alone(?~2=5.151,P=0.023),while the others showed no statistical difference(P>0.05)Conclusion:As for the small lesions whose diameter less than 1cm,unclear boundary and smoking history,which are helpful for detection of meaningful lesion,are the independent risk factors,and the sensitivity of smoking combined with boundary is significantly higher than that of single factor;the differences of specificity does not have an impact on the detection of significant lesions.Thus for patients with BIRADS?3 lesions whose diameter are 1.0 cm or less,if the boundary of lesions is not clear combined with smoking history,surgery is strongly recommended to rule out more severe lesions.