Suspicious non-calcified mammographic findings have not been evaluated with modern mammographic technique, and the purpose of this work is to compare the likelihood of malignancy for those findings. To do this, 5018 consecutive mammographically guided biopsies performed during 2016–2019 at a large metropolitan, community-based hospital system were retrospectively reviewed. In total, 4396 were excluded for targeting calcifications, insufficient follow-up, or missing data. Thirty-seven of 126 masses (29.4%) were malignant, 44 of 194 asymmetries (22.7%) were malignant, and 77 of 302 architectural distortions (AD, 25.5%) were malignant. The combined likelihood of malignancy was 25.4%. Older age was associated with a higher likelihood of malignancy for each imaging finding type (allp≤ 0.006), and a possible ultrasound correlation was associated with a higher likelihood of malignancy when all findings were considered together (p= 0.012). Two-view asymmetries were more frequently malignant than one-view asymmetries (p= 0.03). There were two false-negative biopsies (98.7% sensitivity and 100% specificity). In conclusion, the 25.4% likelihood of malignancy confirms the recommendation for biopsy of suspicious, ultrasound-occult, mammographic findings. Mammographically guided biopsies were highly sensitive and specific in this study. Older patient age and a possible ultrasound correlation should raise concern given the increased likelihood of malignancy in those scenarios.
可疑非钙化性乳腺X线摄影表现尚未通过现代乳腺X线摄影技术进行评估，本研究旨在比较此类表现的恶性可能性。为此，我们回顾性分析了2016年至2019年期间在一家大型都市社区医院系统中连续进行的5018例乳腺X线引导下活检。共排除了4396例针对钙化灶、随访不足或数据缺失的病例。126个肿块中有37个（29.4%）为恶性，194个不对称性病变中有44个（22.7%）为恶性，302个结构扭曲（AD）中有77个（25.5%）为恶性。总体恶性可能性为25.4%。对于每种影像表现类型，年龄较大均与较高的恶性可能性相关（所有p≤0.006）；当综合考虑所有表现时，可能的超声相关性也与较高的恶性可能性相关（p=0.012）。双视角不对称性病变比单视角不对称性病变更常为恶性（p=0.03）。存在两例假阴性活检（敏感性为98.7%，特异性为100%）。总之，25.4%的恶性可能性证实了对可疑、超声隐匿性乳腺X线摄影表现进行活检的建议。在本研究中，乳腺X线引导下活检具有高敏感性和高特异性。鉴于在年龄较大和存在可能的超声相关性情况下恶性可能性增加，应对这些情况提高警惕。
肿瘤(癌症)患者之家