Objective To investigate the utility of full-field digital mammography (FFDM) and localization and biopsy in diagnosis of nonpalpable breast cancer. Methods 42 cases with suspect breast cancer by routine film reading but negative clinical palpation were performed localization and biopsy under X-ray orientation and diagnosed with breast cancer by pathology. The characters of those cases were studied.Results Among 42 cases, 5 cases showed micronodules, 8 cases demonstrated local dense infiltration, 11cases had architecture distortion, 18 cases demonstrated micro-calcifications. The type of pathology comprised of intraductal carcinoma (23 cases), tabular carcinoma in situ (2 cases), early infiltration of ductal carcinoma (12 cases), infiltrating ductal carcinoma (3 cases), papilloma carcinoma (2 cases). Conclusion FFDM can clearly show direct and indirect X-ray signs of breast cancer, combined with localization and biopsy the nonpalpable breast cancer can be easily diagnosed.

Objective To evaluate this disease' s incident trend for Shanxi province through hospital-based statistics. Methods Breast cancer data was obtained from the department of radiology in Shanxi cancer hospital for the period 2005-2007. Results Between 2005 and 2007, the numbers of women who accepted mammography rapidly increased from 533 to 1975. 62 women had been diagnosed as breast cancer in 2005, while this number had reached to 400 in 2007. The proportion of breast malignancies during this three year periods had statistically increased with 11.6 %, 17.8 %, and 20.3 % respectively (P<0.001). The mean age of breast cancer patients was older than benign disease patients (50 vs 42.8, P<0.001). The highest breast cancer age group was those aged 45 to 54 (37.6 %). Left breast cancer was higher than right side (53.4 % vs 46 %). Most histological type was invasive ductal carcinoma (78.95 %). The proportion of invasive lobular carcinoma and duetal carcinoma in situ were 8.7 % and 5.4 % respectively. Conclusion Breast cancer incidence rate has been increased in our city. These results are consistent with previous similar studies. Thus, it is essential to establish population cancer incidence registration and develop clinical data system. This will result in better understanding of cancer incidence trends and benefit in the evaluation of the effective cancer control measures.

Objective To compare the image quality, radiation dose and diagnostic accuracy on film-screen, digital radiography (DR) and computed radiography (CR) mammography. Methods Three different kinds of mammography machines (film-screen, DR and CR) were tested to make sure they were qualified and comparable. Radiographies were taken on Mammo-152 phantom and ACR phantom using filmscreen, DR and CR systems with the same radiation dose. Next, radiographies were taken on two phantoms using DR and CR systems with classic mode or AEC and the radiation dose was recorded. The images were numbered and scored by eight independent experienced radiologists under the same reading condition according to ACR method. Statistics was performed with the randomized complete-block design variance analysis. The diagnostic accuracy of three kinds of mammography methods were compared with Kappa test in clinical cases who had pathologic results. Results The spacial resolution of film-screen system was the highest (7.0-8.0 Lp/mm) and that of CR was the lowest (2.5 Lp/mm). When the radiation dose was increased (27. 0%-30. 0% ), the resolution was improved with DR ( +11. 0% ) but almost no change with CR ( +1.5%). The radiation dose of DR was the lowest on ACR phantom. The delineation of mass was better on film-screen than on CR, but the delineation of fibers and speck was better on CR. When the radiation dose of CR was increased (25. 0% ), the delineation of fibers and speck on CR was similar to that on DR and the delineation of mass was similar to that on film-screen. There was a good correlation between the mammography diagnosis and pathological results (film-screen is 50/56, DR is 83/90 and CR is 61/69,P < 0. 01 and Kappa value > 0. 75) . The diagnostic accuracy of three mammography systems had no statistical difference [film-screen 89. 3% (50/56), DR 92. 2% (83/90) and CR 88. 4% (61/69),Pearson X 2=0. 722 ,P =0. 697]. Conclusion Film/screen system has the highest space resolution and DR has the lowest radiation dose. Three mammography systems have the same diagnostic accuracy for breast disease.

Objective To analyze 278 breast biopsy cases guided by mammography and find the characteristic of the most suitable cases.Methods The initial diagnosis of breast cancer of 278 cases were divided into mass type (197 cases) and non-mass type (81 cases) according to the imaging features,the biopsy was performed in 14G core needle guided by mammography and contrasted to paraffin pathology of post operation.Results The cases of biopsy conformed by paraffin pathology were 260,accuracy rate is 93.52 ％(260/278).192 cases were diagnosed pathologically in 197 cases of mass type,and 68 cases in 81 cases of non-mass type.The accuracy rates were 97.46 ％ (192/197) and 83.95 ％ (68/81) respectively.Conclusion The mass type with clinical and imaging features is suited for biopsy.To avoid missed diagnosis,it is important to frozen during operation for the cases with the negative result in non-mass type.