Journal of the Korean Radiological Society (대한방사선의학회지)

The Korean Society of Radiology (대한영상의학회)
권호 표지

Diagnostic Accuracy of Mammography and Ultrasonography in Detection of Early Breast Cancer

조기유방암에서 유방촬영술과 유방초음파검사의 진단적 가치$^1$

  • Published : 2002.09.01
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Abstract

Purpose: To determine the value of mammography and ultrasonography in the detection of early breast cancer, and the usefulness of combining the two modalities for the diagnostic study of this condition. Materials and Methods: The mammographic and ultrasonographic features of 47 female patients aged 23-68 (average, 46) years with pathologically proven early breast cancer were analyzed retrospectively. Mammography was performed in 46 patients and ultrasonography in 38, and 37 underwent both mammography and ultrasonography. Analysis of the mammographic and/or ultrasonographic features focused on mass, microcalcification, mass with microcalcification, multiple nodules, duct dilatation, and architectural distortion. Results: Mammography revealed microcalcification in 29 (63%) patients, mass in 13 (28%) patients, mass with microcalcification in 8 (17%) patients, multiple nodules in 2 (4%) patients, architectural distortions in 1 (2%) patient, and negative finding in 9 (20%) patients. Ultrasonography revealed mass in 25 (66%) patients, microcalcifcation in 9 (24%) patients, mass with microcalcification in 8 (21%) patients, multiple nodules in 2 (5%) patients, duct dilatation in 3 (8%) patients, and negative finding in 7 (18%) patients. On combined study of mammography and ultrasonography of the 37 patients, mammography or ultrasonography revealed mass in 25 (68%) patients, microcalcification in 20 (54%) patients, multiple nodules in 2 (5%) patients, duct dilatation in 3 (8%) patients, and architectural distortion in 1 (3%) patient. In one (3%) patient among them, both mammography and ultrasonography revealed negative findings. The false negative rate of mammography, ultrasonography or both was 20%, 18%, and 3%, respectively, which was statistically significant difference (p<0.05). Conclusion: Combined study of mammography and ultrasonography is the most useful as a diagnostic study for early breast cancer. So, ultrasonography seems to be the important additional method for detection of early breast cancer.

목적: 조기유방암의 진단에 있어서 유방촬영술과 유방초음파검사의 가치를 알아보고 유방촬영술과 유방초음파검사를 함께 시행하였을 때 진단적 검사로서의 유용성을 알아보고자 하였다. 대상과 방법:수술 후 조직병리학적으로 조기유방암으로 확진된 47명의 수술 전 유방촬영술과 유방초음파검사를 후향적으로 분석하였으며, 연령 분포는 23세부터 68세로 평균 46세였고 모두 여자였다.47예 중 36예가 관상피내암이었고 11예는 침윤성관상피암이었다. 46예에서 유방촬영술을 시행하였고 38예에서 유방초음파검사를 시행하였으며, 이 중 37예에서 유방촬영술과 유방초음파검사를 함께 시행하였다. 분석은 유방촬영술과 유방초음파검사 각각과 유방촬영술과 유방초음파검사를 함께 시행하였을 때 보이는 소견들을 분석하였으며, 종괴, 석회화, 다발성 결절, 유관확장, 유방실질의 왜곡 등의 유무에 따라 분석하였다. 결과: 유방촬영술을 시행한 46예 중 종괴는 없이 미세석회화로만 보인 경우가 29예(63%), 종괴가 있는 경우가 13예(28%)로, 이 중 미세석회화를 동반한 종괴가 8예(17%)였으며, 다발성결절이 2예(4%), 유방실질의 왜곡이 1예(2%), 정상인 경우가 9예(20%)였다. 유방초음파검사를 시행한 38예 중 종괴가 25예(66%), 미세석회화가 9예(24%)로, 이 중 미세석회화를 동반한 종괴가 8예(21%)이었으며, 다발성 결절이 2예(5%), 유관확장이 3예(8%)이었고, 정상인 경우가 7예(18%)이었다. 유방촬영술과 유방초음파검사를 함께 시행한 37예 중 유방촬영술 또는 유방초음파에서 종괴가 25예(68%), 석회화가 20예(54%)이었으며, 다발성 결절이 2예(5%), 유관확장이 3예(8%),유방실질의 왜곡이 1예(3%)이었고, 유방촬영술과 유방초음파 모두에서 정상인 경우가 1예(3%)이었다. 위음성도는 유방촬영술에서 20%, 유방초음파검사에서 18%이었고, 유방촬영술과 유방초음파검사를 함께 시행하였을 때 3%이었다. 유방촬영술 혹은 유방초음파검사를 각각 시행하였을 경우와 비교해 유방촬영술과 유방초음파검사를 함께 시행하였을때 위음성도가 통계적으로 유의하게 낮았다. 결론: 유방촬영술과 유방초음파검사를 모두 시행하는 것이 조기유방암의 진단적 검사로서 가장 유용하므로, 예후가 좋은 조기유방암의 발견을 위한 검사로서 유방초음파검사를 병행하는 것이 필요하다고 생각한다.

Keywords

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