评估乳房肿块

乳腺肿块是一种常见的临床表现，有时可以触及，有时无法触及，既可能是良性的，也可能是恶性的。 大多数可触及的乳腺肿块为良性，但 10% 有该表现的女性可能被诊断为乳腺癌。[1]Barton MB, Elmore JG, Fletcher SW. Breast symptoms among women enrolled in a health maintenance organization: frequency, evaluation, and outcome. Ann Intern Med. 1999 Apr 20;130(8):651-7.http://www.ncbi.nlm.nih.gov/pubmed/10215561?tool=bestpractice.com 大约 4% 的乳腺癌会出现可触及的肿块，但乳腺X线摄影或超声检查无患病证据。[2]Beyer T, Moonka R. Normal mammography and ultrasonography in the setting of palpable breast cancer. Am J Surg. 2003 May;185(5):416-9.http://www.ncbi.nlm.nih.gov/pubmed/12727559?tool=bestpractice.com

乳腺癌诊断延迟或遗漏，会严重影响患者的结局。

根据病史、体格检查、影像学检查和活检发现来进行乳腺肿块评估。 几乎所有病例经临床乳腺检查、影像学检查（例如乳腺X线摄影和超声检查）及针吸活检三联检查可明确确诊。[3]Vetto JT, Pommier RF, Schmidt WA, et al. Diagnosis of palpable breast lesions in younger women by the modified triple test is accurate and cost-effective. Arch Surg. 1996 Sep;131(9):967-72.http://www.ncbi.nlm.nih.gov/pubmed/8790167?tool=bestpractice.com[4]Vetto JT, Pommier RF, Schmidt WA, et al. Use of the "triple test" for palpable breast lesions yields high diagnostic accuracy and cost savings. Am J Surg. 1995 May;169(5):519-22.http://www.ncbi.nlm.nih.gov/pubmed/7747833?tool=bestpractice.com[5]Morris A, Pommier RF, Schmidt WA, et al. Accurate evaluation of palpable breast masses by the triple test score. Arch Surg. 1998 Sep;133(9):930-4.http://archsurg.jamanetwork.com/article.aspx?articleid=211721http://www.ncbi.nlm.nih.gov/pubmed/9749842?tool=bestpractice.com