Abstract: 【Abstract】 Objective〓To investigate the clinical and diagnostic characteristics of mammography (MG) negative breast ductal carcinoma in situ (DCIS) with or without microinvasion. Methods〓From January 2012 to August 2013, clinicpathological data from 32 cases of MG negative DCIS or DCIS-MI were retrospectively analyzed. Results〓Of all MG negative cases, 71.9% (23/32) presented as nipple discharge, 15.6% (5/32) presented as mass, 12.5% (4/32) presented as benign look-like calcifications. High density breast, low nuclear grade, PR positive and HER2 (-) or (+) were significantly higher in MG negative cases than those in MG positive cases (P<0.05). As complementary diagnostic methods for MG negative cases,sensitivity of ultrasound and MRI were 18.7% (6/32) and 87.5% (28/32) respectively. For the cases with nipple discharge, sensitivity of fiberoptic ductoscopy was 52.2% (12/23). Conclusions〓The clinicopathological prognostic index of MG negative DCIS or DCIS-MI is relatively better. MRI and fiberoptic ductoscopy are both beneficial complementary examination for diagnosis of DCIS and DCIS-MI.

Key words: Breast neoplasm, Ductal carcinoma in situ, Mammography, Diagnosis

摘要： 【摘要】〓目的〓探讨乳腺X线检查(MG)阴性的乳腺导管原位癌(DCIS)及DCIS伴微浸润(DCIS-MI)的临床及诊断特点。方法〓对我院2012年1月~2013年8月32例MG检查阴性的DCIS及DCIS-MI的临床病理资料进行回顾性分析。结果〓MG阴性导管原位癌临床表现为单纯乳头溢液占71.9%(23/32),乳腺肿块占15.6%(5/32)例,良性钙化12.5%(4/32)例。MG检查阴性导管原位癌中腺体高密度、低核分级、PR阳性、HER2(-)或(+)病例的比例明显高于同期MG检查阳性组,且差异有统计学意义(P<0.05)。补充其他诊断检查的结果显示,乳腺超声敏感性为18.7%(6/32),磁共振(MRI)敏感性可达为87.5%(28/32),对表现为乳头溢液的病例,乳管镜诊断的敏感性为52.2%(12/23)。结论〓MG阴性的导管原位癌临床病理生物学指标相对较好,MRI检查可进一步提高其检出率,乳管镜对于乳头溢液的病例是有益的补充检查手段。

关键词: 乳腺肿瘤, 导管原位癌, 乳腺X线检查, 诊断