What are the common X-ray manifestations of breast cancer?

Breast cancer patients can have the following basic X-ray signs on X-ray plain films.

(1) direct sign

① lump or localized dense shadow. Mass is the most common and basic X-ray sign of breast cancer. It is characterized by irregular or lobulated block shadows, and can also be round or oval; There are many burrs, uneven edges, or thick tentacles; The density is higher than that of surrounding glands; The mass size measured by X-ray is smaller than that obtained by clinical palpation, which is an important basis for malignant lesions. Localized dense shadows are also common manifestations of breast cancer.

Sometimes, because the cancer tissue spreads along the mammary duct, no obvious lump is formed, or because the inflammatory reaction around the cancer is obvious, the lump is covered up. X-rays are mostly dense, and the edge of the lesion may have burrs or pseudo-podiform protrusions.

② Calcification. Calcification sign is an important X-ray sign in the diagnosis of breast cancer. The forms of calcification can be varied, such as granular, short rod-shaped or earthworm-shaped, round or oval, or fine sand-shaped, which generally does not exceed 0.5mm, and the number is 10, which can be counted as many as three or five. Calcification points exist not only in the shadow of the mass, but also outside the shadow of the mass, sometimes densely distributed along the mammary duct. For small cancers within 1cm, there is no obvious mass shadow, and specific calcification can often be used as the only diagnostic basis.

(2) Indirect signs

① The blood supply increased obviously. It shows that the diameter of one side of blood vessel is obviously thicker than that of the other side; Most small vascular shadows appear around the lesion; Large drainage veins appeared in the lesion area. This sign mostly appears in the middle and late stage of breast cancer.

② Thickening or local depression of the skin.

③ Recent unilateral nipple retraction.

④ Asymmetrical tube shadow thickening.

⑤ Distorted breast structure.

⑥ Invasion of the posterior breast space. It is characterized by localized occlusion or complete disappearance of the transparent line in the posterior mammary space. This sign can only be shown by mammography.

⑦ Invasion of internal mammary lymph nodes or axillary lymph nodes. Axillary X-ray photography is taken under high conditions, and if there is local lymph node metastasis, it can be displayed on X-ray.

The above signs are mainly masses, localized dense infiltration, calcification and burr.