Breast cancer: molybdenum target examination

Molybdenum target examination is painless. Breast cancer is a common breast tumor in women. The incidence of breast cancer is increasing year by year, and it has become the first killer of urban women in China. In clinical diagnosis and examination, mammography is one of the most effective and reliable means to diagnose breast lesions. Mammography of breast cancer is summarized as follows:

Clinical symptoms of 1

The common symptoms of breast cancer mainly include lump, skin change, nipple areola change, nipple discharge, pain and axillary lymph node enlargement. Breast lump is the earliest clinical symptom of breast cancer, and it is also the reason for most patients to see a doctor. More than one or more, the quality is as elastic as hard leather, and the surface is smooth and easy to push. The menstrual cycle has no effect on the size of the tumor.

2 Clinical diagnosis

Mammography of breast cancer can be divided into two categories: primary signs and secondary signs. The former includes mass, localized dense infiltration, malignant calcification and burr; The latter includes skin thickening and localized depression ("dimple sign"), nipple invagination and funnel sign, increased blood supply, positive catheter sign, "edema ring" around tumor, comet tail sign and so on. There are two or more main signs, or 1 main sign plus two or more secondary signs, which can establish the diagnosis of breast cancer. The only exception is calcification. When X-ray shows typical malignant calcification, it can also be diagnosed as breast cancer, although it is not accompanied by other malignant signs.

Main manifestations of molybdenum target x-ray in breast cancer

3. 1 quality

Mass is the most common and basic X-ray sign of breast cancer. About 70% of breast cancer patients can clearly show the shadow of the tumor on X-ray films, and the shadow density of cancerous tumors is dense in most cases, which is higher than that of benign tumors of the same size. A small number of cancer tumors may have transparent cavity-like shadows due to necrosis and liquefaction, such as papillary carcinoma, cystadenocarcinoma and medullary carcinoma. From the naked eye, the density of mass shadow is not only related to the density of mass itself, but also depends on the density contrast between mass and surrounding background. Masses with the same density are very dense if they occur on rich adipose tissue background; On the contrary, if it is on the background of dense mammary glands, it appears lighter, only slightly higher than the density of glands or even completely covered by the shadow of dense glands.

Breast cancer masses are mostly round, lobulated or irregular. In a few cases, it has a strange shape, which can be gourd-shaped, petal-shaped or kidney-shaped.

3.2 Limited intensive infiltration

When the density of a certain area of the breast increases abnormally, or asymmetric dense areas appear on both sides of the breast, it is called localized dense infiltration. This sign is benign in most cases (about 2 or 3), such as hyperplasia and chronic inflammation. About 1, 3 is caused by cancer, especially lobular cancer. About 26% of breast cancer shows limited dense infiltration. The vast majority of cancerous infiltration is denser than normal glands, especially in the central part, which gradually fades outward and is submerged in the shadow of normal glands, so the boundary with normal tissues is often difficult to determine.

3.3 Malignant calcification

Malignant calcification plays a particularly important role in the diagnosis of breast cancer. As the main X-ray sign of breast cancer, it is not only helpful for the diagnosis of breast cancer, but also has 4% ~ 10% cases. Calcification is the only positive basis for the diagnosis of breast cancer. At least 50% ~ 60% of the so-called clinical breast cancer without mass is diagnosed solely by calcification, of which about 30% is carcinoma in situ, and about 70% is ductal carcinoma, early invasive carcinoma or invasive carcinoma.

Most calcified particles of breast cancer are calcium phosphate, and a few are calcium oxalate. The latter is not dyed in standard hematoxylin-eosin staining, but can only be seen in polarizing microscope. Histologically, calcification does not necessarily occur in malignant tissue areas. Calcification is mostly located in the degenerative and necrotic area of cancer cells in the lumen of ductal carcinoma. On X-ray films, most of them are piles of deposits or needle-like calcification, and a few are calcification of necrotic cancer cells themselves. Calcification can also occur in necrotic cell fragments infiltrating the edge of cancer. In solid cancer, calcification can be located in the cancer nest, showing irregular calcification points. In adenocarcinoma, calcification can be located in the glandular cavity, or in the mucus matrix of mucinous adenocarcinoma, and part of calcification can be located in the lumen or matrix of the terminal mammary duct of normal breast adjacent to cancer.

3.4 burr

Spike sign is also an important X-ray sign of breast cancer, which is usually found at the edge or infiltration area of the mass. This sign can be seen in about 40% of breast cancer, and burrs are found in more than 60% of cancerous masses. Occasionally, the image of cancer itself is not obvious, and the X-ray film only shows a slender or thick burr image radiating around. The reason of burr sign may be due to interstitial reaction around cancer, direct infiltration and expansion of cancer, expansion of cancer along breast duct or traction of bundle structure around cancer to tumor. Hard cancer has obvious fibroproliferative reaction, so obvious burr often appears on X-ray films, which can reach several times the diameter of the tumor, and even the burr sign masks the image of the tumor itself. On the X-ray film, the shape of burr is varied, which can be expressed as short sharp-pointed protrusion, long and thick tentacles, slender, pseudopodia, flame-like, irregular and so on. In some cases, the burr is small, and it must be observed with a magnifying glass or enlarged photography to identify it.