Abstract:

Objective

To retrospectively analyze the clinicopathologic features of breast cancer patients with false-negative mammograms.

Methods

Two hundred thirty-three female patients with primary breast cancer diagnosed by pathology or confirmed by operation in our hospital between January 2007 and December 2010 were involved in this study, with complete data on preoperative mammogram, high-frequency color Doppler ultrasound and pathological examination. They were divided into false-negative group and truepositive group according to the preoperative mammography. Patients' age, tumor size, lymph node involvement, histological type and hormone receptor expression were compared between 2 groups. The results of preoperative ultrasonography in the false-negative group were also analyzed.

Results

Of the 233 patients,10.7% (25/233) were negative in mammogram. The onset age in false-negative group was (44.23±9.62)years, lower than (53.41±11.63) years in true-positive group (t=3.061,P=0.004); the tumor diameter in false-negative group was (2.93±0.78) cm, smaller than (3.48±1.12) cm in true-positive group (t=3.536,P=0.007). The false-negative group had a higher proportion of infiltrating carcinoma than true-positive group(92% vs 64.4%,χ²=7.72,P=0.005) and a lower rate of estrogen receptor expression (36% vs 63.5%,χ²=7.04,P=0.008). The preoperative ultrasound images in all 25 false-negative patients indicated clear tumor and the diagnosis accordance rate of malignancy was 68%.

Conclusions

Breast cancer patients with falsenegative mammograms have younger onset age,dense gland tissue,small tumor size,and a lower rate of estrogen receptor expression, mostly invasive. The mammogram combined with ultrasound examination can increase the detection rate and improve diagnostic accuracy.

Key words: breast neoplasms, mammography, false negative reactions