MRI finds preinvasive stages of aggressive breast cancer twice as often as mammography. 磁共振发现癌前阶段侵袭性乳腺癌的两倍常常为乳腺.

University of Bonn - A study in the Lancet (vol. 370, 11 August 2007) could lead to a change of paradigm in the early diagnosis of breast cancer.波恩大学的一项最新研究发现,在刺胳针 ( 370卷, 2007年8月11日) ,可能会导致一种范式的改变,在乳腺癌早期诊断. It states that magnetic resonance imaging (MRI) is substantially more accurate than mammography in diagnosing very early stages of breast cancer .它指出,磁共振成像( mri ) ,实质上是更准确比乳腺诊断非常早期的乳腺癌. Up to now MRI was thought to be hardly suited for the detection of such ‘ductal carcinoma in situ’ (DCIS) .截至目前磁共振被认为难以适于检测这种'导管原位癌(导管原位癌) . Researchers at the University of Bonn have now come to a completely different conclusion.研究者在波恩大学,现在已经到了一个完全不同的结论. In the past five years they examined more than 7000 women with both methods.在过去5年来,他们研究了7000多名妇女的两种方法. In a total of 167 women the doctors found early forms of breast cancer – 152 (92 %) of these were found using MRT, 93 (56 %) with mammography.一共有167名妇女,医生发现早期形式乳腺癌152 ( 92 % ) ,这些被发现使用捷运, 93 ( 56 % )与乳腺.

Breast cancer forms in the cells which line the inside walls of the milk ducts.乳腺癌的形式在细胞线内壁的乳导管. The tumor initially remains in the milk duct and is therefore called “intraductal cancer” or DCIS (ductal carcinoma in situ).肿瘤初期仍停留在乳管,因而也被称为"导管癌"或导管原位癌(导管原位癌) . Although even at this stage it is called a carcinoma, it behaves actually like a benign disease, which can always be treated successfully by operating on it.但即使在这个阶段,它被称为癌,它的行为其实就像一个良性疾病,可随时治疗成功经营. Only when the tumor grows out of the milk ducts into the breast’s glandular tissue can it spread via blood and lymph vessels in the body.只有当肿瘤生长出来的乳管进入乳房的腺体组织,它可以传播是通过血液和淋巴管在体内. ‘If we find DCIS and remove it we can prevent the formation of “real” breast cancer,’ the Bonn radiologist Professor Christiane Kuhl explains. '如果我们发现导管原位癌和清除它,我们可以防止形成"真正的"乳腺癌的波恩放射学教授克里斯蒂安闹春解释. ‘That way we prevent the development of a disease that is often life-threatening.’ '这样,我们可以防止开发的一种疾病,往往危及生命. '

However, there are different forms of intraductal carcinomas: the less aggressive (low-grade) and highly aggressive (high-grade) DCIS.不过,也有不同形式的导管内癌: 83.56 (低年级)和高侵略性(高年级)导管原位癌. Whereas low-grade DCIS is relatively inert and may never spread beyond the milk duct (and thus may never pose a threat to the women affected), high-grade DCIS will virtually always break out of the milk ducts, and then will become dangerous, biologically aggressive high grade invasive breast cancer.而低品位导管原位癌是相对惰性,而且可能永远也波及乳导管(从而可能永远不会威胁到女性的影响) ,高品位,将导管原位癌几乎总是摆脱奶槽,然后将成为危险的,生物侵略性高品位侵袭性乳腺癌. This makes it all the more important to discover such high-grade DCIS.这就显得更为重要了,发现这种高档导管原位癌.

Up until now mammography was the ‘gold standard’ of breast cancer medicine 直至现在乳腺'黄金标准' ,乳腺癌药

It has been known for a long time that MRI is superior to mammography as far as the diagnosis of invasive breast cancer is concerned.它已经认识很久,磁共振优于乳腺至于诊断侵袭性乳腺癌而言. However, the search for DCIS to date has been the preserve of mammography.然而寻找dcis组织迄今为止一直保留乳腺. It highlights small calcifications which form in the milk ducts affected.它突出了小钙化形成,在乳管的影响. On the MRI scan, depositions of this kind are invisible.对磁共振扫描,证言,这种无形的. Therefore MRI was hitherto seen as unsuited for detecting intraductal carcinoma, which was one of the main reasons for only using mammography for the early detection of breast cancer.磁共振成像,因此是迄今为止被视为不适于探测导管癌,其中一个主要的原因,只不过是用乳腺,为乳腺癌的早期发现.

With their results the Bonn researchers confounded this textbook wisdom.其结果波恩研究者混淆了这本教科书的智慧. A total of 7319 women were investigated by Professor Kuhl and her colleagues in the last five years using both methods.一共有7319名妇女进行调查闹春教授和她的同事们在过去的5年,用两种方法. In 167 of them they found early stages of breast cancer. 167人,他们发现早期乳腺癌. ‘Using mammography only 93 cases of DCIS could be seen, compared with 153 cases detected by MRT,’ is how Professor Kuhl sums up the results. '用乳腺只有93例导管原位癌可以看出,相比153例检测捷运, '是如何教授闹春总结成果. ‘And not only that: it was above all the particularly aggressive high-grade DCIS which were especially reliably picked up using MRI, but especially difficult to detect using mammography.’ '不仅如此:它是以上所有侵略性特别高等级dcis组织,其中特别可靠拾起利用磁共振成像,而且还特别容易被发现乳腺用. '

A total of 89 cases of high-grade DCIS were discovered by the doctors in the course of the study. MRI detected 98 per cent of these aggressive pre-invasive breast cancers, with mammography only detecting 52 per cent .共89例高等级dcis组织发现,由医生在研究过程中. 磁共振发现98 %以上的侵略性前侵入性乳癌,乳腺检测中,只有52 % . The reason for this was that as it appears, in particular the fast growing tumors do not develop the calcifications which constitute the basis of mammographic DCIS diagnosis.之所以如此,原因是他看来,特别是在快速成长的肿瘤不发展钙化构成基本乳腺导管原位癌的诊断. Instead, these DCIS are pervaded by many small blood vessels in which the contrast medium that is injected for an MRT scan collects particularly well.相反,这些导管原位癌充满了许多小血管,其中造影剂是注入一个捷运扫描收集特别好.

Professor Kuhl concludes from this that ’Our study demolishes a whole series of textbook dogmas.闹春教授由此推断' ,我们的研究拆了一系列教科书的教条. Firstly, it was always said that MRT was not able to find early stages of breast cancer in the milk ducts.首先,它总是说,捷运是不是能够找到早期乳癌的乳管. As our results show, the opposite is true.正如我们的研究结果显示,事实恰恰相反. MRT is far more sensitive than mammography.’ The second prejudice is that MRT often leads to ‘false positives’, i.e. often causes ‘false alarms’.捷运更为敏感乳房. '第二个偏见是捷运往往导致'假阳性' ,即经常引起'虚惊' . ‘Among our patients that was even less the case with MRI than with mammography,’ Professor Kuhl emphasizes. '中的病人来说,更是少的情况比磁共振成像与乳房的闹春教授强调. ‘The positive predictive value of MRT was 59 per cent, compared to 55 per cent for mammography.’ The third point was that until now it was assumed that MRI was only necessary for early detection of breast cancer in women with an increased risk of breast cancer. '阳性预测值,捷运是59 % , 55 %为乳腺. '第三点是,直至现在,它被假定磁共振只需要早期发现乳癌的妇女中的风险增加乳房癌症. Yet many of the participants had taken part in the study as part of the perfectly normal cancer check-up.然而,不少学员参加了学习,作为部分的完全正常的癌症检查. The conclusion of the Bonn research team is that MRI can improve the diagnosis of very early stages of breast cancer significantly, not simply with high-risk groups, but with all women.结束波恩研究小组是扫描可提高诊断非常早期乳腺癌明显,不仅仅是高危人群,而且与所有妇女.

Expertise in MRI breast cancer detection needed 专长在磁共振检测乳腺癌需要

However, Professor Kuhl does not want the Bonn results to be used as an argument against current mammography screening programs.然而,教授闹春不想波恩结果被用来作为反对当前的乳癌筛检方案. ‘Mammography is a basic examination that is essential for early detection.’ MRI is not yet ready for use as a mass screening tool. '乳腺是一个基本的检查是必不可少的早期检测.磁共振是尚未准备用作筛检工具. ‘Too little use is made of the method in the field of breast imaging, so correspondingly there are too few radiologists who have been able to gain sufficient experience with this specific application,’ she says. '使用太少了,是该方法在外地乳腺影像,所以相应地也有少数人放射科已能取得足够的经验,这与具体应用, '她说. ‘In order to evaluate the MRI scans, an experienced eye is needed. '为了评价磁共振扫描技术,有经验的眼睛是必要的. It is the radiologist that diagnoses the patient, not the magnet.它是放射诊断,病人,而不是磁铁. In order to find these pre-invasive stages of breast cancer on an MRI scan, the images need to be evaluated according to specific criteria.为了找到这些预阶段侵袭性乳腺癌的核磁共振扫描,图像需要加以评估,根据具体准则. Unfortunately awareness of this is not yet sufficiently widespread’ (Courtesy of EurekAlert!, a service of AAAS).可惜对此的认识尚不够广' (礼貌风行! ,服务促会) .