古屋 隆俊

Takatoshi FURUYA

山梨医科大学第二外科

The Second Department or Surgery, Yamanashi Medical College

キーワード : Echographic mobility, Dynamic scanning, Pathological margin, Breast tumor

We have been attempting differential diagnosis of breast tumors using dynamic scanning since 1988, which consists of an evaluation of mobility and compressibility of the tumors. Among the two factors, tumor mobility is quite useful for differential diagnosis. Although evaluation of mobility depends highly on the skill and experience of the examiner, we try to clarify to what degree the evaluation of the mobility reflects the pathological marginal morphology of the breast tumors.
64 breast tumors were examined for the relationship between echographic mobility and pathological marginal morphology. 16 were fibroadenomas, 15 were mastopathies, and 33 were breast cancer.
Echographic mobility is defined as follows: when the tumor is movable against surrounding tissue (subcutaneous fat or mammary gland), then mobility is (+). When it is fixed to or movable only with surrounding tissue, then mobility is (-). Pathological marginal morphology is classified into two types: capsulated, regularly-shaped, or rounded margin is defined as smooth (S-type), whereas invasive, irregularly-shaped, or unclear margin is defined as irregular (I-type).
The coincidence rates (mobility (+) and S-type, or mobility (-) and I-type) are 93.8% (15/16) in fibroadenomas, 93.3% (14/15) in mastopathies 97.0% (32/33) in breast cancer, and 95.3% (61/64) for all tumors.
Mobility on palpation is merely indicative that the tumor has not invaded the skin or fascia and is useless for differential diagnosis of small breast tumors. Echographic evaluation on the mobility may be subjective, but is proved to be fairly reliable to diagnosing pathological, marginally invasive or expansive growth.