【Abstract】Objective To assess the value of 99Tcm-tetrofosmin imaging in discriminating malignant mass from benign breast mass.Methods From June 2000 to January 2002, 104 patients with breast mass detected by clinical examination were included. After 740 MBq 99Tcm-tetrofosmin was injected intravenously in the contralateral arm to the breast lesion, the front and the lateral images were collected in 5 min, 10 min and 20 min respectively. 99Tcm-tetrofosmin imaging localized in breast was defined as the positive sign of affinitive tumor. All patients underwent operation within one week. Using histological assessment as a golden standard, the sensitivity, specificity, positive and negative predictive value for 99Tcm-tetrofosmin SPECT of the breast were calculated respectively. Results The sensitivity of 99Tcm-tetrofosmin imaging for discriminating between malignant mass and benign mass in palpable breast lesions was 87%, specificity 84%, positive and negative predictive value were 85% and 86% respectively. Conclusion The results suggested that 99Tcm-tetrofosmin imaging is a valuable tool for distinguishing between malignant mass and benign mass in palpable breast lesions.
【Abstract】Objective To estimate the value of the infra-red light scanning and the colored ultrasonic Doppler in diagnosis of breast masses. Methods Two hundred and seventy nine patients with breast mass were examined with the infrared light scanning and the colored ultrasonic Doppler in our hospital.Following the two examinations the masses were resected and pathologically examined as a control. Results The conformity of the infra-red light scanning with pathologic diagnosis was 94.0% in 182 hyperplasia masses, while that of the ultrasonic Doppler was 84.6%(P＜0.01). The conformity of the infra-red light scanning with pathology was 91.7% and that of the colored ultrasonic Doppler was 83.3%(Pgt;0.05). The colored ultrasonic Doppler was seemingly more effective than infrared light scanning in diagnosing 9 galactocele and 5 intraductal papilloma, but there is no significant difference(Pgt;0.05). The conformity of the two exams with pathology in 59 fibroadenoma was almost the same.Conclusion The infra-red light scanning is more effective than the colored ultrasonic Doppler in diagnosing the hyperplasia masses, there is no significant difference in diagnosing the breast cancer and the fibroadenoma between the two exams. Combined use of this two exams would increase the accurase of the breast masses.
ObjectiveTo systematically review the clinical value of the contrast-enhanced ultrasonic in the diagnosis of breast tumors. MethodsWe electronically and comprehensively searched the databases including The Cochrane Library (Issue 2, 2013), PubMed, CNKI, WanFang Data, Chaoxing medalink, VIP, and CBM for clinical research reports of diagnosing breast cancer with Contrast-enhance ultrasonic (all from foundation to May 2013). Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies according to the QUADAS items. The Meta-DiSc software (version 1.4) was used to conduct pooling on sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio. Heterogeneity test was performed and the summary receiver operating characteristic (SROC) curve was drawn for area under the curve (AUC). ResultsA total of 19 studies involving 1 161 participants were included. The results of meta-analysis showed that, specificity, the pooled sensitivity, positive likelihood ratio, negative likelihood ratio and DOR were 0.79 (95%CI 0.75 to 0.82), 0.86 (95%CI 0.83 to 0.89), 3.92 (95%CI 2.77 to 6.56), 0.18 (95%CI 0.13 to 0.26), and 25.86 (95%CI 13.77 to 48.55), respectively. The AUC of the SROC curve was 0.917 0. ConclusionThe current evidence shows that contrast-enhanced ultrasonic has high sensitivity and specificity in the diagnosis of preoperative benign and malignant breast mass, which indicates that it could be used as a good method to diagnosing breast tumors.
Objective To explore the risk factors of perioperative insomnia in young patients with breast masses undergoing ambulatory Mammotome (MMT) minimally invasive surgery. Methods A total of 166 young female patients who were ≤40 years old, diagnosed with breast masses, undergoing ambulatory MMT between June and December 2016 in West China Hospital of Sichuan University were included in this study. Questionnaire survey and data about general condition, preoperative and postoperative Insomnia Severity Index (ISI), Hospital Anxiety and Depression Scale, and postoperative pain Visual Analogue Scale were collected in the enrolled population. Univariate analysis was used to screen the factors that might cause insomnia, and then multiple logistic regression analysis was performed to identify possible risk factors of insomnia. Results In the 166 young female patients, the mean age was (30.90±5.96) years, and the mean perioperative ISI score was 8.83±4.97. Slight insomnia was found in 39.7% (66/166) of the patients, moderate insomnia was found in 12.7% (21/166), and severe insomnia was found in 2.4% (4/166). The results of multiple logistic regression suggested that the number of breast masses [taking the number=1 as the reference, when the number=4, odds ratio (OR)=2.269, 95% confidence interval (CI) (1.917, 13.818), P=0.001; when the number>4,OR=9.359, 95%CI (4.507, 19.433), P<0.001] and the maximum diameter of breast masses [taking 1–10 mm as the reference, when the maximum diameter was 26–30 mm,OR=6.989, 95%CI (1.488, 32.785), P=0.014; when the maximum diameter >30 mm, OR=17.290, 95%CI (4.664, 64.071), P<0.001] were independent risk factors of the severity of perioperative insomnia in these young women. Conclusion It is recommended that psychological nursing and comprehensive admission education should be enhanced for young patients who have >3 breast masses or the diameter of the mass is >25 mm, aiming to improve the postoperative recovery of patients with high risk of insomnia.
ObjectiveTo explore the scientific method of hospital disease cost management under the disease payment system.MethodsThe data of " breast mass” disease in the case hospital of 2018 were collected, and the cost accounting of the disease was calculated by the income and expenditure ratio method, cost-to-charge ratio method, project-adding method, clinical path method, and activity cost method, respectively. Comprehensive evaluation was conducted for the five methods.ResultsThe direct costs of the disease calculated by income and expenditure ratio method, cost-to-charge ratio method, project-adding method, clinical path method, and activity-based cost method were 3 021.14, 3 387.79, 3 744.45, 3 997.44, and 4 297.18 yuan, respectively, and accounting for 63%, 67%, 70%, 74%, and 80% of total cost, respectively. The standard deviations of direct cost were 514.37, 495.23, 231.22, 317.33, and 197.47, respectively, of which the standard deviation of direct cost of the activity-based costing method was the smallest. The comprehensive scores of key performance indicator of the income and expenditure ratio method, cost-to-charge ratio method, project-adding method, clinical path method, and activity-based cost method were 4.15, 5.40, 7.85, 7.10, and 8.55, respectively.ConclusionsIn terms of the cost results and index evaluation of the disease, the activity-based costing method is the optimal method. The accounting process is close to the real path, which can track the cost drivers, enhance the cost controllability, and is conducive to the management of disease resource consumption.